Peter O'Donnell Jr. Brain Institute
Second Opinion - Terms and Conditions
UT SOUTHWESTERN PETER O’DONNELL JR. BRAIN INSTITUTE
REMOTE SECOND OPINION CONSULTATION PROGRAM
TERMS AND CONDITIONS
You are 18 years of age or older and intend to pursue an educational second opinion consultation with The University of Texas Southwestern Medical Center (“UTSW”). As a condition of participation in this service offered by UTSW, you hereby acknowledge the following terms and conditions of UTSW’S Remote Second Opinion Consultation Program:
1. UTSW Remote Second Opinion Consultation Program. The purpose of UTSW’S Second Opinion Consultation Program (the “Program”) is to give consumers and their physicians’ access to additional information which they may or may not choose to utilize in planning medical and health care. It is not a substitute for primary care or in-person care and no physician-patient relationship is created by use of this program. The professionals providing services through this program will not have the benefit of information that would be obtained by examining you in person and observing your physical condition. Therefore, the professionals providing services through this Program may not be aware of facts or information that would affect his or her opinion of your diagnosis or treatment. To reduce the risk to you of this limitation, UTSW strongly encourages you to discuss any information provided through the Program with your local physician. By deciding to engage the services through this Program, you acknowledge and agree that you are aware of this limitation and agree to assume the risk of this limitation. Furthermore, you agree and accept that (i) the information you will receive is limited and provisional; (ii) the second opinion is not intended to be or replace a full medical evaluation or an in-person visit with a physician; (iii) the professionals providing services through this Program do not have important information that is usually obtained through a physical examination; (iv) the absence of a physical examination may affect the professional’s ability to provide information to you relevant to your condition, disease or injury, and (v) no warranty or guarantee has been made to you as to any particular result, outcome, treatment or cure. Please note that this Program is only offered to Texas Residents at this time.
2. Use of Opinion & Information. All evaluative observations provided through the Program are in no way construed to be determinative of the treatment to be pursued by your treating medical professionals. THE CONSULTS, INFORMATION AND MATERIALS PROVIDED BY THE PROGRAM ARE INTENDED SOLELY FOR INDIVIDUALS SEEKING GENERAL INFORMATION ABOUT MEDICAL PROCEDURES, AND ARE NOT INTENDED FOR INDIVIDUALS OR PATIENTS SEEKING MEDICAL ADVICE OR TREATMENT. YOUR PARTICIPATION IN THE PROGRAM DOES NOT CREATE A PHYSICIAN-PATIENT RELATIONSHIP AND DOES NOT OBLIGATE UTSW OR ITS PHYSICIANS OR PROVIDERS TO FOLLOW-UP OR CONTACT YOU. Only you, with input from your healthcare provider, primary care physician, and/or treating physician, may decide if the use of the information obtained from the Program would be beneficial to your medical treatment. Ask your health care provider, primary care physician, and/or treating physician if your diagnosis and/or prescribed treatment protocol may benefit from the Program.
3. Medical Emergencies. If you are experiencing a medical emergency, dial 911 or go to the nearest emergency room. If you have an urgent medical question, please call your provider’s office to schedule an appointment.
4. Limitations; Indemnification. You understand and agree that UTSW shall have no responsibility or liability for any services provided or withheld by any third party, whether or not based on the information provided to you through the Program. You agree that the second opinion will not be used in any legal dispute including but not limited to litigation, arbitration, claim for disability benefits, claim for workers’ compensation and/or malpractice claims without the prior written consent of UTSW. You agree to defend, indemnify, and hold harmless the UTSW Parties (as defined below) from and against any and all claims, liabilities, and expenses (including attorneys’ fees), relating to services that you obtain from third parties, whether or not based on the information provided to you through the Program.
5. Independent Advice and Informed Choices. You understand that it is your responsibility to make any decisions regarding treatment solely based upon your own independent investigation of, and upon any discussions you may have had with your own health care providers other advisors.
6. No Reliance on UTSW Representations. You further understand and agree that you are not relying on any representations or warranties from UTSW, the University of Texas System, and their respective Regents, or their respective directors, officers, employees, medical staff, agents, representatives, successors, and assigns (the “UTSW Parties”).
7. No Guarantee. You acknowledge and agree that UTSW does not guarantee your participation in the Program as each circumstance is unique and the Program may not be appropriate for you. In the event UTSW determines that you are not an appropriate candidate for the Program, UTSW will notify you and return any records or information provided. You also may be eligible for a refund.
8. Complete and Accurate Information. You agree that all healthcare information and records provided by you or on your behalf to UTSW shall be true, accurate, and complete to the best of your knowledge, and that you understand that UTSW will be relying upon the truth, accuracy, and completeness of such healthcare information and records in exercising their own judgment in providing relevant information to you pursuant to the Program. You shall indemnify, defend, and hold harmless the UTSW Parties from and against any liability arising from any falsity, inaccuracy, or incompleteness of information or records supplied by or on behalf of you.
9. Resolving Disputes. You agree that these Terms and Conditions shall be governed by and construed in accordance with the laws of the State of Texas, United States and that any dispute that may arise between you and UTSW relating to the Program or these Terms and Conditions must be resolved in Dallas, Texas United States.
10. Translation Services. These Terms and Conditions are written in English. You understand and agree that it is solely your responsibility to engage a certified translator of your choice to translate these Terms and Conditions and any information provided to you in connection with the Program in your native language during your review of these Terms and Conditions and prior to your signature. Any inconsistency between the provisions in English and any other language shall, to the full extent permitted by applicable law, be resolved by reference to the English version.
11. Credit Card Transactions. At this time, UT Southwestern only accepts credit card payments for service(s) provided under the Program. When you pay for any service provided by UTSW hereunder using your credit card, UTSW, in its sole discretion, reserves the right to accept or reject payment from your credit card. By requesting payment by credit card payment, you hereby authorize UTSW to bill and charge the credit card in U.S. dollars for the amount indicated in your order, including any fees, taxes, and other required charges as the same become due and payable. In the event UTSW elects to so accept payment, UTSW shall debit the applicable amounts from your credit card. In the event that your credit card expires or UTSW is otherwise unable to debit the applicable amounts from your credit card, UTSW shall provide notice to you, whereupon you immediately shall furnish in writing to UTSW a valid credit card account number. You agree that you are fully responsible for payment of any services rendered to you by UTSW that you have requested here under.