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Booking Form for Online Appointment with Dr. Hatem Eleishi

Service Information

The online consultation with Dr. Hatem Eleishi is conducted in two steps:
One: Submit your complaint through this form for review by the clinic to ensure your case is suitable for an online interview.
Two: After the clinic's approval, we will contact you to schedule the interview and complete the payment procedures.

Consultation Fee: $99. The service includes a video interview with written follow-up for 28 days (a full month) after the interview.
Important Note: The online consultation service on the Tabibakom platform is not available inside Egypt. If you are in Egypt, please contact Dr. Hatem's clinic in Cairo to book an appointment through the Cairo clinic WhatsApp: 00201011179397

Payment Method: Via a payment link for Visa card or any alternative method agreed upon with the booking office.

When will I receive the appointment: Usually within two to four working days from the date of contact to book an appointment.

Interview Duration: Depends on the patient's condition: usually 20 to 40 minutes. An additional interview can be arranged thereafter without extra fees during the same four-week period if the patient's condition requires it (e.g., waiting for new test results).

Program Used: The online clinic has its own link on the medical consultation program (Doxy.me). The online clinic sends it to the patient and no download is needed: just click on the link.

Attending Physician: If the patient wishes for their general practitioner following their case in their country to attend the interview, Dr. Hatem very much welcomes that and would be happy to communicate with the treating physician afterwards regarding the patient's condition.

Communication with Dr. Hatem after the interview: After the patient receives the medical opinion and treatment plan, the patient will have written communications without additional fees for a full month to inquire about anything new regarding their condition. This is done through a special communication platform for Dr. Hatem Eleishi's patients (Motawassel platform) and we send the patient the service link, username, and password for their medical file. Responses to inquiries are provided within two working days.

Subsequent Consultations: After the month following Dr. Hatem's interview ends, whether the patient has used this period for communications or not, the consultation ends. The patient can book other new consultations afterwards (weeks or months) as required by their condition or as agreed upon with Dr. Hatem.

Free Consultations: If you need a free inquiry, you can send it to Dr. Hatem in the comments on this specific video on the YouTube channel: https://www.youtube.com/watch?v=eLrab4Xqfe0

Personal and Medical Information

Patient's Full Name

Age

Gender

Are you the patient, or are you filling out this form on behalf of someone else? If you are not the patient, please specify the relationship.

Your WhatsApp number so we can contact you to coordinate and confirm the appointment

Country of residence

Primary complaint or concern

Main reason for requesting this consultation

Check the box next to any of the following conditions if previously diagnosed by a rheumatologist

If you have any available and recent medical reports, blood tests, or radiology reports (preferably from the last 3 to 6 months), please attach them here

Are you currently taking any medications for a rheumatic or autoimmune condition?

Are you currently taking prescribed medications from more than one medical specialty?

A
B

What is the approximate number of prescribed medications you take regularly?

A
B
C
D
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Do you have any additional notes you would like to mention about your condition?

One of the assistant doctors may contact you on WhatsApp or the phone number provided here for further inquiries before booking the appointment.

We wish you continued health and wellness.