E-CONSULT Follow-up

The E-CONSULT is not a formal professional interaction, it is an informational session with Dr. Lonner or his team. A formal professional consultation must be conducted in person.

Full Name*
Prefix First Last
Date of Birth*
MM slash DD slash YYYY
Phone Number*
E-mail*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please Describe Your Condition for Dr. Lonner. How/When did it Start? Do You Have Pain? If So, Where?
Please upload prior operative reports, pertinent physician/specialist visits, x-rays, CTs and MRIs. *In addition to uploading your images/reports, also kindly mail any images (Xrays, CT, MRI) to 5 East 98th Street, 4th floor New York, NY 10029. Please make sure all CDs being sent are in DICOM compatible format.
File
Max. file size: 50 MB.
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Product Price*
- Review of x-rays and 15 minute follow-up Zoom call with Dr. Lonner $200.00
- Review of x-rays and follow-up Zoom call with physician assistant $100.00
* Tele-Health Follow Up will be provided within 2 weeks of receiving payment

212-241-8947

E-CONSULT Follow-up

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