Find Your Provider
What is the name of the provider with whom you are seeking to have a telehealth visit?
VSee cannot guarantee the security and confidentiality of an e-mail transmission. VSee is not liable for breaches of confidentiality caused by yourself or a third party. I understand the risks of unencrypted email and do hereby give permission to VSee to send me personal health information (PHI) via unencrypted email.
Never submit passwords through Google Forms.
This form was created inside of VSee.
Terms of Service