PLEASE NOTE: This form should ONLY be used by patients with a scheduled telemedicine visit. Please help us ensure our telemedicine visits go smoothly and our staff resources are managed well. Please do not submit this form if you do not have a scheduled telemedicine visit. Thank you!
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Hello! If your online telemedicine visit involves a health concern that the pediatrician will need to see clearly, please submit your photo(s) in advance. This will help in case the video quality or internet connection is not optimal during your visit.
- Enter your name, your child's name, your child's date of birth, and the PHCA office where your visit was scheduled. This will be used to identify the photos for your child's telemedicine visit.
- Click "Choose File"
- Select photo from your phone or computer
- IMPORTANT: Click green "Upload" button - this is the final step to attach the photo to your submission. The button turns red when the upload is complete
- Repeat steps 2 through 4 if you have additional photos
- Click "Submit"
Your photo submission will be sent to the office you selected in the form. Thank you and we look forward to your online telemedicine visit with PHCA.