Welcome to the TVSC telemedicine program. Here you will find basic information needed for completing and scheduling a patient referral to our specialists.

Choose a specialty:

Allergy and Immunology :

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Allergy & Immunology Guidelines
• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Cardiology:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Cardiology Guidelines
• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Diabetes Education:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Diabetes Education Guidelines
• Diabetes Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

HIV/Hep C:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• HIV/Hep C Guidelines
• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Pulmonology:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Pulmonology Guidelines
• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Orthopedics:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Orthopedics Guidelines
• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Pediatric Guidelines
• Telemedicine Referral
• Child History Form
• Telemedicine Consent Form
• ODCHC Registration Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Telemedicine Referral
• ODCHC Registration Form
• Behavioral Health Consent Form
• Behavioral Health Intake Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Gynecology:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Telemedicine Referral
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

Psychiatry:

1. For the basic forms you will need to get started, click on the appropriate link below and download the Adobe PDF document.

• Psychiatry Guidelines
• Psychiatry Referral Form
• ODCHC Registration Form
• Telemedicine Consent Form

2. Once they are completed, please fax them to (707) 442-4039

3. Next, please call (707) 442-4038 to schedule an appointment for your patient.

To view our monthly calendar of telemedicine clinics, click here on the TVSC Home page!