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Some information is critical to the physician to be able to provide you with an objective opinion.

Thank you for your interest in US Expert Medical Opinion. Please choose the department below and review the checklist to start with your expert medical opinion request.

Please feel free to contact us if you have any questions regarding the process of obtaining a US Expert Medical Opinion. We look forward to providing you with an exceptional service.

*If you don’t find or know the department you are looking for, contact us, we will try to help you.

Cardiac surgery

Please review the checklist requested by your USEMO specialist, and gather as many reports as possible before submitting for an opinion. If more information is needed, you will be contacted by the physician.

Cardiac Surgery Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Echocardiogram
Stress test
Cardiac catheterization

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
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Your First and Last Name (required)

Your Email (required)

Phone Number (required)

Cardiology

Cardiology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Echocardiogram
Holter monitor or event monitor
Stress test
Cardiac catheterization
Tilt table test
Implanted device interrogation (pacemaker, defibrillator, implantable loop recorder)

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Electrophysiology

Electrophysiology Surgery Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Echocardiogram
Holter monitor or event monitor
Stress test
Cardiac catheterization
Tilt table test
Implanted device interrogation (pacemaker, defibrillator, implantable loop recorder)

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Step 3
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

General Surgery

General Surgery Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pertinent lab tests such as Lipase, Thyroid function, Tumor Markers
Nuclear scans or Endoscopy results
Biopsy results

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Geriatrics

Geriatrics Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pulmonary function tests
Nuclear scan or PET scan
Biopsy result
Cardiac tests like Echocardiogram or stress test

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our We transfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Gynecology

Gynecology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Hematology

Hematology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pertinent lab results such as Tumor markers
Nuclear scans or PET scan
Pathology results

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy (HBOT) Checklist

1- Please provide us with a brief statement regarding:

⁃ Your current medical problem – Indicate the onset/ duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

⁃ Brief medical/surgical history ⁃ Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

⁃ Lab results from blood tests such as CBC, CMP. ⁃ Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

– Vascular ultrasound

– Radiation.

– surgical treatments to the affected area

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Hospice Care

Hospice Care Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Interventional Radiology

Interventional Radiology Checklist

1- Please provide us with a brief statement regarding:

⁃ Your current medical problem – Indicate the onset/ duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

⁃ Brief medical / surgical history ⁃ Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

⁃ Lab results from blood tests such as CBC, CMP. ⁃ Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

– Echocardiogram – Stress test – Cardiac catheterization

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Obstetrics

Obstetrics Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Oncology

Oncology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pertinent lab results such as Tumor markers
Nuclear scans or PET scan
Pathology results
Previous cancer treatment

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Ophthalmology

Ophthalmology Checklist

1- Please provide us with a brief statement regarding:

⁃ Your current medical problem
– Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

⁃ Brief medical / surgical history
⁃ Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

⁃ Lab results from blood tests such as CBC, CMP.
⁃ Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

– Recent Testing including where applicable, photography of the eye or retina
– Ocular computerized tomography
– Topography
– A-Scans
– B-Scan
– Pachymetry
– Fluorescein angiography
– Electroretinography
– Visual evoked potential testing

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Orthopaedic Surgery

Orthopaedic Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Physical therapy report
Nuclear scan or Myelogram

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Palliative Care

Palliative Care Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Notes
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Pediatric

Pediatric Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button at the end of the form.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Pediatric Hematology

Pediatric Hematology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pertinent lab results such as Tumor markers
Nuclear scans or PET scan
Pathology results
Previous cancer treatment

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Pediatric Oncology

Pediatric Oncology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pertinent lab results such as Tumor markers
Nuclear scans or PET scan
Pathology results
Previous cancer treatment

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Psychiatry

Psychiatry Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pulmonary function tests
Nuclear scan or PET scan
Biopsy result
Cardiac tests like Echocardiogram or stress test

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our We transfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Pulmonology

Pulmonology Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pulmonary function test
Sleep study
Echocardiogram

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Spine Surgery

Spine Surgery Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Physical therapy report
Nuclear scan or Myelogram

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Sports Medicine

Sports Medicine Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Physical therapy report
Nuclear scan or Myelogram

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Thoracic Surgery

Thoracic Surgery Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Pulmonary function tests
Nuclear scan or PET scan
Biopsy result
Cardiac tests like Echocardiogram or stress test

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Urology

Urology Checklist

1- Please provide us with a brief statement regarding:

⁃ Your current medical problem – Indicate the onset/ duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

⁃ Brief medical/surgical history ⁃ Your current medical problem and/or treatment plan

4- Please provide us, if available, with reports of:

– Vascular ultrasound

– Radiation.

– surgical treatments to the affected area

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)

Vascular Surgery

Vascular Checklist

1- Please provide us with a brief statement regarding:

Your current medical problem
Indicate the onset / duration of this problem

2⁃ Please indicate the questions you like addressed regarding this problem

3- Please provide us with any available reports from your treating physician that include:

Brief medical / surgical history
Your current medical problem and/or treatment plan

4- Please provide us with any available reports of :

Lab results from blood tests such as CBC, CMP.
Radiographic data such as X-rays, CT scan, MRI.

5- Please provide us, if available, with reports of:

Vascular ultrasounds or MRA
Angiogram or angioplasty of vessels
Cardiac tests like Echocardiogram or stress test

Ready to Submit all your information?

If more information is needed, you will be contacted by the specialist. Also, if you are trying to upload dicom (.dcm) extension files, please use our Wetransfer plus button.

Introduction
Note
Step 1
Step 2
Upload Files
Submit

Your Name (required)

Your Email (required)

Phone Number (required)