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+39 06 40 06 14 02
clinic@firstmedcenters.it
+39 338 312 6331

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Telemedicine Appointment Registration

Register for a Telemedicine Appointment

Fill out the form below and our team will contact you to schedule your virtual consultation.

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Email

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Patient's Name*

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Patient's Nationality*

Patient's Date of Birth*

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Email*

Phone Number*

Please include your country code

Residential Address*

Street Address

Street and Building Number, City, Postal Code, Country

Please select which clinic team you'd like to have your online consultation with.*

While you can meet with our doctors online from anywhere in Italy, our team conducts telemedicine consultations from either our Rome or Milan clinics. In the event that you require an original prescription to be mailed or picked up, a follow-up appointment, or further treatment in-person, please select which clinic team is most convenient for you.

Select the reason for your visit from the list below.

For concerns or specialties not listed, please first contact us to inquire.

⚠︎ The following medications cannot be prescribed through telemedicine:

Antiviral Covid-19 medication (paxlovid), Diabetes medications, ADHD medications (e.g. adderall, ritalin), Benzodiazepines (e.g. xanax, valium), Narcotic pain medications (e.g. oxycodone, codeine)

Select a specialty*

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Select your concern*

Select your concern*

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⚠︎ If you are experiencing swelling of the face, lips, or difficulty breathing, please seek emergency care.

⚠︎ If you are experiencing eye pain or blurred vision, please seek in-person care.

Please provide any additional details below.*

⚠︎ If you are experiencing chest pain, shortness of breath, pain associated with injury, or severe pain, please seek emergency care.

Please provide any additional details below.*

⚠︎ If you are experiencing bloody stool or severe abdominal pain please seek emergency care.

Please provide any additional details below.*

⚠︎ If you are experiencing chest pain, shortness of breath, or coughing blood, please seek emergency care.

⚠︎ For asthmatic symptoms, please seek in-person care.

Please provide any additional details below.*

⚠︎ If you are experiencing bloody stool, high fever (≥ 39.5°C / 103°F), or severe pain, please seek emergency care.

Please provide any additional details below.*

⚠︎ Earache accompanied by severe pain, hearing loss, or discharge may require an in-person examination.

Please provide any additional details below.*

⚠︎ COVID-19 - Due to local restrictions, Paxlovid cannot be prescribed.

⚠︎ For temperatures above or equal to 39.5°C / 103°F, please seek emergency care.
⚠︎ If you're experiencing confusion or shortness of breath, please seek emergency care.

Please provide any additional details below.*

⚠︎ COVID-19 - Due to local restrictions, Paxlovid cannot be prescribed.

⚠︎ If you are experiencing difficulty breathing, high fever (≥ 39.5°C / 103°F), or chest pain, please seek emergency care.

Please provide any additional details below.*

⚠︎ Follow-up telemedicine appointments are available only when recommended by your FirstTelemed physician. If you are unsure, please contact us.

Please provide the reason for your follow-up and any other details for the doctor to review.*

⚠︎ If you are experiencing persistant vomiting, severe dehydration, or blood in vomit or stool, please seek emergency care.

Please provide any additional details below.*

⚠︎ If you are experiencing difficulty swallowing or unintentional weight loss, please seek an in person evaluation.

Please provide any additional details below.*

⚠︎ If your current blood pressure is greater than or equal to 180/120 mmHg, please seek emergency care.
⚠︎ If you are experiencing chest pain, please seek emergency care.

Please provide any additional details below.*

(No warnings for this concern)

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Were your lab tests ordered by a FirstMed Physician?*

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Please provide any additional details below.*

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If possible, please upload a copy of your lab results.

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 25 MB.

⚠︎ If you're experiencing a sudden severe headache, please seek emergency care.
⚠︎ If you are experiencing confusion, or neurological symptoms, please seek emergency care.

Please provide any additional details below.*

⚠︎ If you are experiencing swelling around the eyes or severe headache, please seek in-person care.

Please provide any additional details below.*

⚠︎ If you're vomiting blood, experiencing high fever (≥ 39.5°C / 103°F), or severe dehydration, please seek emergency care.

Please provide any additional details below.*

⚠︎ If you are also experiencing pain, light sensitivity, or blurred vision, please seek in-person care.

Please provide any additional details below.*

Please provide any additional details below.*

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

⚠︎ If this is your first time taking this medication or you do not have a recent prescription, please schedule an in-person appointment.

Please provide any additional details below.*

Please upload a copy of your existing prescription; showing the patient’s name, medication name, dosage, date of issue, and the prescribing physician’s full name and signature. If the prescribing doctor’s contact info is not listed, please include it in the text box above.

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 25 MB.

Please provide any additional details below.*

⚠︎ If you are unable to swallow liquids or experiencing difficulty breathing, please seek emergency care.

Please provide any additional details below.*

Please provide any additional details below.*

Please provide any additional details below.*

⚠︎ If you are experiencing fever, back, or flank pain, please seek in-person care.

Please provide any additional details below.*

Please provide any additional details below.*

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Please provide any additional details below.*

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⚠︎ If you are experiencing difficulty breathing or dizziness, please seek emergency care.

Please provide any additional details below.*

Please provide any additional details below.*

⚠︎ If you are experiencing spreading redness or fever, please seek in-person care.

Please provide any additional details below.*

⚠︎ If you are experiencing fever or chills, please seek urgent care.

Please provide any additional details below.*

⚠︎ Please note: diabetes medications cannot be prescribed via telemedicine.

⚠︎ Please note: diabetes medications cannot be prescribed via telemedicine.

Please provide any relevant information for the doctor to review.*

⚠︎ If you do not currently take contraceptives and would like to begin taking them, please schedule an in-person appointment.

Please describe your concern.*

Please provide any additional details below.*

Please provide more details. Are your symptoms recent, chronic, or a result of injury?*

Vaccination Consult details*

General Medicine

Price:

General Medicine Telemedicine Consultation - Currently discounted from €65 to €45

STD Screening

Price:

General Medicine Telemedicine Consultation

Dermatology

Price:

Specialist Telemedicine Consultation

Endocrinology

Price:

Specialist Telemedicine Consultation

Gynecology

Price:

Specialist Telemedicine Consultation

Orthopedics

Price:

Specialist Telemedicine Consultation

Pediatrics

Price:

Specialist Telemedicine Consultation

Total

⚠︎ General Note: If the doctor determines a prescription is necessary for your treatment, the prescription will be provided in digital format.

While many pharmacies in Italy accept digital prescriptions, some may require a printed copy or even the original prescription. We recommend printing your prescription before going to the pharmacy.

If you are unable to print it, you may need to try more than one pharmacy. Please note that the acceptance of digital prescriptions is determined by the pharmacy and is outside the clinic’s control.

If the medication requires an original prescription, the clinic can mail the prescription to you for an additional shipping fee determined by location and urgency.

Please specify your availability.

After your payment has been submitted, our staff will email you within 1 business day (excluding holidays) with your appointment date, time, and access link. If your scheduled time doesn’t work for you, let us know at least 24 hours before your appointment to avoid a no-show, rescheduling, or cancellation fee. You'll also receive an automated text message reminder 24 hours before your virtual appointment.

Which days of the week work best for you?*

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Which times of day work best for you?*

Morning

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Terms and Conditions reports agreement*

I have read and agree to the terms & conditions and privacy policy.

In-person agreement*

I understand that if my concern cannot be fully addressed online, I may be referred for in-person evaluation.

Email reports agreement*

I agree to receive healthcare reports via email.

By clicking the pay button below you can choose to pay with PayPal, debit card, or credit card.

Please note that telemedicine appointments are self-pay services. Insurance is not accepted for FirstMed Telemedicine.

Payment Method*

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Supported Credit Cards: American Express, Discover, MasterCard, Visa

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24-hour telephone assistance: +39 06 40 06 14 02

International Private Clinic network

FirstMed is an international-standard healthcare company providing English-language outpatient care in Europe. Its flagship clinic, founded in Budapest, Hungary, in 1999, has consistently been recognized as one of the best healthcare centers in the region. The company has also incorporated in Italy, and is opening further centers across the region soon as part of its ambitious expansion program.

ROME

+39 06 40 06 14 02
+39 338 312 6331
RomeClinic@firstmedcenters.it
firstmedcenters.it
Via Morgagni 30/H Roma 00161

MILAN

+39 02 8112 7935
+39 338 312 6331
MilanClinic@firstmedcenters.it
firstmedcenters.it
Via Laghetto, 3, Milan 20122

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