ANNA CHRISTINA V.

CUSI, MD, DPPS, DPSDBP

Diplomate, Philippine Pediatric Society
Diplomate, Philippine Society of Developmental and Behavioral Pediatrics
MAAYO WELL CEBU
North Park, UN Ave corner Plaridel St, Alang-Alang, Mandaue City, Cebu
Contact Number: 0917-581-2516

ONLINE CONSULTATION INSTRUCTIONS

CONSULTATION
An average consultation last from 60-90 minutes.
The professional fee is Php3500 (three thousand five hundred pesos). This will entitle you to one (1) consultation.

TO SCHEDULE AN APPOINTMENT
Kindly:
1. fill up and sign the consent form, pp 2 & 3

2. Deposit payment to:

BANK: BPI (Bank of the Philippine Islands)
ACCOUNT: Savings Account
ACCOUNT NAME: Marissa V. Cusi
ACCOUNT NUMBER: 2946-0243-67

FOR NEW PATIENTS

An initial intake form under file name New-History-Form-Dr Cusi is attached.
 Please answer until page 5 to the best of your abilities. You may skip questions you are not sure of.

EMAIL BACK to us at iamdrcusi2@gmail.com

o Proof of payment
o Filled up & signed consent forms
o Accomplished history form
o all pertinent documents (if any) described below:
• previous developmental assessments,
• school or therapy reports,
• any other documents that you think will be important for this consult
NOTE: Incomplete requirements will put your appointment on hold

CONFIRM APPOINTMENT
You will then be given a schedule for your appointment.
A zoom link will be sent 30 minutes before your schedule.
If you cannot make it on the said appointment due to certain circumstances, please inform us at least
48 hours before your schedule or your payment will be forfeited.

PLEASE PREPARE THE FOLLOWING BEFORE THE CONSULTATION

Be sure that your child is well rested, not hungry, and not sick.
Please log in at least 10 minutes before your scheduled zoom appointment to check the audio and video connections.
Check the internet connection and look for a location with the best possible signal. Ensure the room is
secure, private, quiet, and well lit.
Wear headphones for better audio, if available.
Angle the camera so that there is a good view of the parent and patient.
At least one guardian/parent has to be with the patient.
If the internet connection on either end gets disconnected, the physician will try to call the guardian/parent to either continue the
consultation, try re‐connecting again, or to re‐schedule the consult.