Medical Second Opinion (Ulink Assist)
Please complete to the fullest extent in order to get a more meaningful second opinion
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Email *
Name *
Describe your symptoms
(e.g. chest pain, weight loss, blood in urine etc.)
What is your current doctor's specialty?
(e.g. cardiologist, orthopedic surgeon etc.)
What is the diagnosis provided by your current doctor?
When were you diagnosed?
What treatment have you been recommended/undergone? *
(e.g. medication, chemotherapy, surgery etc.)
What investigations have you done?
(e.g. blood test, CT scan, MRI etc.)
What other chronic illnesses do you have?
(e.g. high cholesterol, diabetes, high blood pressure etc.)
Why are you requesting for a second opinion?
(you can tick more than 1)
Is there anything else that would be useful for the doctor to know?
Email us your medical records.
As with all medical second opinions, the more information provided the more accurate the opinion will be.

Gmail: https://goo.gl/A1hoVH    |    Outlook: http://is.gd/D2QSuM    |    Others: ops@ulinkassist.com
Personal Data Protection Act (PDPA)

In accordance with Singapore's PDPA, Ulink Assist undertakes to keep strictly confidential any information provided by you.
I consent to and authorise Ulink Assist Pte Ltd to disclose and release my medical records and any individually identifiable health information concerning my medical condition to the necessary and relevant healthcare providers who may be involved in my medical second opinion. *
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