Telemedicine Survey

 

Are you conducting telemedicine at your Practice?

What year did you start offering telemedicine?

Name of service you use:

 

First Name

 

Last Name

 

Designation (MD,DO, etc.)


Medical Lisc Number  


Group\Practice Name



Specialty  (IM, ENT, FP, etc.)

 

Additional Comments


To update your contact information or if you have questions about Membership please contact membership@bcms.org or call (210) 301-4398.

Click Submit only once. Thank you.