Remote Medical Second Opinion Deposit Payment

$1,500 Deposit

To begin specialist matching

Applied toward your total balance

This deposit secures your spot and allows our team to begin preparing, coordinating, and scheduling your U.S. medical second opinion.

Patient / Representative Information

What Happens After You Pay

1. Immediate confirmation sent to your email

2. Our team reviews your medical records and case details

3. We match you with the right U.S. specialist for your case

4. You approve the physician profile before we proceed

5. Regular updates keep you informed every step of the way

Acknowledgment & Authorization

By signing below, I confirm that:

• The deposit is required to begin the physician matching process.

• The deposit is non-refundable once the case is submitted to an agreed-upon physician.

• I authorize the payment amount selected above.