Peer-to-Peer Consulting

Case Review Upload

Use the form below to start the case review process.  Provide a brief overview of your case and we will contact you for the next step of the process.  (Note that files may also be uploaded with this form). New clients will be invoiced in advance for 30 minutes time which must be paid before your session. Additional time will be billed if necessary at the current P2P rates ( see Clinic Help Desk for Details)

 

First Name (required)

Family Name (required)

Suffix

Professional/Clinical Speciality

Institution/Company/Organization

Contact Email (required)

Contact Phone

Reason for Consult Brief Description

Your Case File Upload