Telepsychiatry Provider Profile

Residence:

Would you be willing to consider obtaining additional state licenses?

Yes

Do you treat Children?

Yes

Do you treat Medicare patients?

Yes

Do you treat Medicaid patients?

Yes

Would you like to consider providing telemedicine services to your existing patients and/or to new patients on-line through e-Psychiatry�s secure, HIPAA compliant videoconference platform?

Yes

Are you willing to provide telepsychiatry services to patients in urgent/emergent settings?

Yes

Most clients pay for services by the hour. Would you also consider fee-for-service/PRN work?

Yes

Are you Board Certified?

Yes

Are you Board Eligible?

Yes

Do you have your own medical malpractice insurance?

Yes

Highlights of your Areas of Specialization and Expertise:

Experience:

Nursing homes/Long-term Care?

Yes

Schools/Universities?

Yes

Prisons/Correctional Facilities?

Yes

Telemedicine Experience? (Experience NOT required � we will train)

Yes

How many hours per week would you ideally like to commit to telemedicine?

Compensation: Telemedicine providers avoid the office, staff & travel expenses of a traditional practice, allowing you to keep more of the $ you make, and to be more competitive in your rates than providers in office settings. The competitiveness of your proposed compensation is a key criterion Clients consider when selecting providers for hire.

What fee per hour of service would you like to represent to potential clients?
IF you want to consider full time employment, what total compensation (salary + benefits) are you willing to represent to potential clients?

Is there anything else you would like us to know?

1. Please email your CV to Provider.Relations@e-Psychiatry.com immediately after completing this form.

2. e-Psychiatry conducts confidential background checks on providers as part of our matching services.

3. We welcome you to update this profile in the future as new information becomes available.

4. e-Psychiatry will continue to alert you to potential employment and consulting opportunities as they become available.

* Required Fields

Thank you for you interest in working with e-Psychiatry.

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Telepsychiatry Provider Profile: For Psychiatrists, Nurse Practitioners & Psychologists