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MyMedicalOpinion

Welcome to MyMedicalOpinion. Thank you for trusting us with your case. This form takes about 5 minutes to complete. Please have the following ready:

Patient Details

Diagnosis Information

List of Documents you have

Everything you share is completely confidential.

IMPORTANT — PLEASE READ BEFORE PROCEEDING. MyMedicalOpinion provides remote specialist comments from GMC registered UK NHS specialists based on medical documents you submit. This is NOT: → An emergency medical service → A clinical diagnosis service → A treatment prescription service → A replacement for your treating physician. This IS: → An independent professional review of your medical documents → A specialist comment to help you make more informed decisions → An advisory service to support discussions with your doctor. If this is a medical emergency please call emergency services immediately. For any questions contact: mymedicalopinion@gmail.com

Your Full Name (person filing the form)

Patients Full Name

Which tier service you paid for?

Your WhatsApp number, including country code E.g. +91 for India +44 for UK

Your Email address (Reports will be sent on this email address)

Your relationship to the patient

What type of specialist do you need?

What has the patient been diagnosed with? (Please describe the diagnosis in as much detail as possible)

What treatment or Surgery has been recommended?

How urgent is this?

Which documents do you have available to upload?

Doctors recommendation letter

Blood Test results

MRI or CT scan results

X-Ray report

Ultrasound Report

Biopsy or Pathology Report

ECG Report

Angiogram Report

Echo Report

Medication List

Other Report

Please upload your medical documents

Size limit: 10 MB

What is your main question for the specialist? (What do you most want the specialist to address? e.g. Is this surgery necessary? Is this the right treatment plan?)

Is there anything else you would like the specialist to know?

Please confirm

I understand this is a second opinion service and does not replace my treating doctor

Please confirm

I consent to my Patient's medical information being shared with GMC registered UK specialist for review

Please Confirm

I confirm the information I have provided is accurate

Please confirm

I have read and agree to the terms of service at mymedicalopinion.com

Disclaimer 1 — Data Transfer and Processing

I understand and consent to the following regarding my medical data: My medical records and personal health information will be securely transferred to and processed in the United Kingdom by My Medical Opinion Ltd, a company registered in England and Wales. My data will be stored on encrypted, GDPR compliant servers located within the United Kingdom. My medical records will be shared solely with the GMC registered UK NHS specialist assigned to review my case and with no other third party. All medical records, documents and personal data submitted will be permanently and irreversibly deleted within 7 days of the specialist comment being delivered to me. I have the right to request deletion of my data at any time before the comment is delivered by contacting mymedicalopinion@gmail.com

Disclaimer 2 — Nature of the Comment

I understand the following regarding the nature of this service: The comments provided by My Medical Opinion are a remote second review based solely on the medical documents, reports, and information submitted by me through this platform. The UK specialist has NOT physically examined the patient. The comment is NOT a clinical diagnosis made following a face-to-face consultation. The specialist's comment is based exclusively on the documents provided and represents their professional view of those documents only.The comment provided is advisory in nature and does NOT constitute:→ A formal medical diagnosis→ A treatment plan→ A prescription→ A recommendation to change any ongoing treatment→ A substitute for in-person medical consultation.I understand that the comment should be used solely as additional information to inform discussions with my primary treating physician and NOT as a basis to independently change, stop or alter any current medical treatment without first consulting my treating doctor.

Disclaimer 3 — Accuracy of Information

I confirm that:All medical documents, reports and information submitted are genuine, unaltered and accurately represent the patient's medical situation to the best of my knowledge. I understand that the qualitya nd accuracy of the specialist's comment is entirely dependent on the accuracy and completeness of the information and documents I have provided. MyMedicalOpinion Ltd accepts no liability for any comment that is based on incomplete, inaccurate or misleading information provided by me

Disclaimer 4 — Limitation of Liability

I understand and accept that: My Medical Opinion Ltd is a technology platform that facilitates connections between patients and independent GMC registered medical specialists. My Medical Opinion Ltd is not a medical practice, clinic or hospital and does not employ the specialists who provide comments through the platform. Each specialist operates as an independent medical professional and is solely responsible for the content of their comment. My Medical Opinion Ltd, its directors, employees and contractors accept no liability for any medical decisions made by me or on behalf of the patient based on the specialist comment provided. Any and all medical decisions remain the sole responsibility of the patient and their primary treating physician.

Disclaimer 5 — Emergency Situations

I understand that: My Medical Opinion is NOT an emergency medical service. If the patient is experiencing a medical emergency, I will contact the relevant emergency services immediately in local geographical location rather than submitting a case through this platform. The standard review turnaround of 72 hours and emergency review turnaround of 12-24 hours are not appropriate for life threatening emergencies requiring immediate medical attention.

Disclaimer 6 — Terms and Privacy

I confirm that: I am over 18 years of age or am the legal guardian of the patient on whose behalf I am submitting this case. I have read, understood and agree to the full Terms of Service available at mymedicalopinion.com/terms. I have read, understood and agree to the Privacy Policy available at mymedicalopinion.com/privacy. I consent to being contacted by My Medical Opinion Ltd via WhatsApp and email regarding my case submission at mymedicalopinion@gmail.com

Disclaimer 7 — Refund Policy

I understand the refund policy: If My Medical Opinion Ltd is unable to find a suitable GMC registered specialist for my specific case within 24 hours of payment — a full refund will be issued to my original payment method within 5-10 business days. If a specialist has already reviewed my case and delivered a comment — no refund will be issued as the service has been fully rendered. If I am unsatisfied with the comment received I may contact mymedicalopinion@gmail.comwithin 48 hours of delivery to discuss my concerns.

MyMedicalOpinion

Your Full Name (person filing the form)

Patients Full Name

Which tier service you paid for?

Your WhatsApp number, including country code E.g. +91 for India +44 for UK

Your Email address (Reports will be sent on this email address)

Your relationship to the patient

What type of specialist do you need?

What has the patient been diagnosed with? (Please describe the diagnosis in as much detail as possible)

What treatment or Surgery has been recommended?

How urgent is this?

Which documents do you have available to upload?

Please upload your medical documents

What is your main question for the specialist? (What do you most want the specialist to address? e.g. Is this surgery necessary? Is this the right treatment plan?)

Is there anything else you would like the specialist to know?

Please confirm

Please confirm

Please Confirm

Please confirm

Disclaimer 1 — Data Transfer and Processing

Disclaimer 2 — Nature of the Comment

Disclaimer 3 — Accuracy of Information

Disclaimer 4 — Limitation of Liability

Disclaimer 5 — Emergency Situations

Disclaimer 6 — Terms and Privacy

Disclaimer 7 — Refund Policy

How did you hear about MyMedicalOpinion?