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Medical Procedure

For each medical procedure being screened for, Qualiphy maintains a list of necessary
medical history questions and screening criteria, including contraindications. It is the
responsibility of the Medical Director of the Clinic to determine whether Qualiphy’s
screening questions and criteria are sufficient.
The Medical Director understands that the Medical Director has the ability to change or
add to the standard screening questions and exam criteria provided by Qualiphy.
Additionally, the Medical Director understands that the Medical Director can add
comments or instructions for the Qualiphy screening provider to review prior to the
completion of the screening exam.
The Medical Director of the Clinic has reviewed the screening questions, feels that
they are adequate and sufficient for the medical treatment(s) for which the screening
is being provided, and has made all necessary changes, additions, and comments and
instructions.