Example Form 2 | Riverton Medical

Riverton Medical Disclaimer

I understand virtual visits do not substitute the need for in office visits, as in office visits provide a more thorough exam. I will not hold Riverton Medical PLLC liable for a provider's lack of physical findings. I also recognize if any symptoms are present, I must notify the provider during the time of the virtual visit. I also agree to seek help from a primary health provider, or specialist with an in-office visit, visit the urgent care, or proceed to the Emergency Room. I understand Riverton Medical does not have an “on call” provider and if any concerns exist, I must contact the ER, urgent care, or other primary care provider or specialist. I also recognize some prescribed medications may be recommended "off label." and I assume and accept the risks of using medications in this manner. I also understand I must contact my primary care provider and schedule an in-office visit if I am experiencing side effects or an adverse reactions from usage of prescribed medications. I agree I will not hold Riverton Medical PLLC liable for any such side effects or adverse reactions to medications. Riverton Medical DOES NOT COMPLETE PRIOR AUTHORIZATION FORMS. I also understand Riverton Medical LLC provides focused or limited primary care and performance medicine and I must have a permanent primary care provider for evaluation and treatment of all medical and health conditions. By typing your name below, you accept the above conditions. Electronic Signature

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Riverton Medical Disclaimer ​

Riverton Medical Disclaimer