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 or call (210) 301-4398.

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