CONSULTATION SERVICES 

Edward Lichten, M.D.,PC
555 South Old Woodward Suite #700
Birmingham, MI 48009 
248.593.9999
Email: drlichten@yahoo.com

  

OVERVIEW:

Edward Lichten, M.D. offers a telephone consultation for a fee of two hundred and fifty dollars ($250).  Pertinent medical history and laboratory testing are reviewed in this 20-30 minutes period. As this is a telephone consultation, there is no real or implied physician-patient relationship and the discussion is for informational purposes only.

Should the patient initiating the consultation wish to have a physician-patient relationship they are urged to see their local physician or call the office of Dr. Edward Lichten’s office for an appointment.

 

For more information on making an appointment for a consultation:

  call: 1(866) 532.4254 and be advised to mail the requested material and the payment information to the address listed below.

 

Be sure to include physical copies of:

 

[    ]  Laboratory Testing

 

[    ] Medical Computer History

 

[   ] Individual’s full name, address, city, state zip code, telephone number and Email address with check or credit card information:

 

First Name

 

Last Name

 

Address Number

 

Address Street

 

City

 

State Zipcode

 

Telephone number

 

Email

 

Best time to call

 

Best Day of week

 

 

Credit Card Type      (Circle One)

MC, VISA, Discover, American Express

16 digit account number

 

Expiration date

 

V code

 

Name on Card

 

Signature authorizing charges

 

 

 

MAKE CHECKS PAYABLE TO EDWARD LICHTEN, M.D., P.C.

CONSULTATION SERVICE

189 Townsend Street 2nd floor

BIRMINGHAM, MI 48009

 

For questions about completing the form, contact the assistant at CONSULTATION REQUEST: CALL 1-248-593.9999