To request an online second opinion from Cleveland Clinic, your first step will include registering registering to use our secure site. Once you have established your user name and password (your secure account), you can access Cleveland Clinic's online second opinion service from any computer with Internet access. You may make a request on behalf of someone else if you have the patient's permission, however, the patient will need to complete a proxy form and include it in the package that is sent to Cleveland Clinic. We will also request a consent or proxy form from the patient which will enable our Cleveland Clinic physician to render your second opinion.

If this service is being provided by your employer as a part of your benefits package, you may need to contact your human resources department for additional information or instruction about the benefit as it applies to you or your beneficiary.

Once you are logged in, you will be in a secure Web environment which means any information you send to us can only be read by you and Cleveland Clinic. (See our privacy policy for more information.)

There are seven steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-45 minutes to complete. A helpful hint that we recommend:

• Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process.
• The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

Below is a brief description of the information being requested in each step of the online process:

Step 1— Requestor Information
This initial step only applies if the individual requesting the online second opinion is someone other than the patient that needs the second opinion. We ask the requestor basic information such as name, address, date of birth etc... If you are the actual patient requesting the second opinion, you can skip to step 2.

Step 2— Patient Information
In this step we ask for information about the patient which includes name, address, date of birth, etc.

Step 3— Diagnosis or Problem
In this step, we will need to know the diagnosis the patient was given on his or her first opinion. If you aren't sure, type in a general term and then choose from the list given. We will then let you know if we have a physician specialist available who can render an opinion for your specific condition.

Step 4— Payment Process
In this step, your credit card information will be required to process your request for a second opinion. We will not charge your credit card until your second opinion is completed and ready for your review. If you are receiving this service as a benefit from your employer, you will not be required to enter your credit card information.

Step 5— Medical History
In this step, we ask for detailed information about the diagnosis from the first opinion and medical history information which includes history of symptoms, any treatment received to date, medications, prior illnesses, etc.. Since this step is very specific, we recommend that the medical records for the patient needing/requesting a second opinion are available for easy reference.

Step 6— Requested Materials
In this section, we provide lists and forms for you to print out to assist in completing your second opinion request. We ask for actual films or studies that are necessary for our physicians to perform a thorough second opinion. For your convenience, you may print this checklist and take it to the doctor or hospital where the patient's tests were performed. Your checklist will also include mailing instructions for all of the necessary items to be mailed to us.

Step 7— Review and Final Approval
This section allows you to review and change any of the information you have provided. If you are charging the service to your credit card, this step also authorizes us to charge your card. The charge will be posted on your credit card when your second opinion is complete. Once you have submitted your opinion request, you may check on the status of your opinion by logging on to our Web site and logging on to your secure account that you created during the registration process. The opinion status will be displayed on the home page.

We will notify you by email when your opinion is ready to view in your secure online account.