Zulqarnain MD PC
Effective Date: May 1, 2026
1. INTRODUCTIONZulqarnain MD PC (“we,” “us,” or “our”) is committed to protecting the privacy and security of individuals who access our website and services. This document describes how we collect, use, disclose, and safeguard personal information, and outlines the terms governing use of our website, telehealth services, and SMS communications.By accessing this website or using our services, you agree to the terms outlined in this document.
2. SCOPE OF SERVICESZulqarnain MD PC provides telehealth consultation services, including pulmonary and critical care second opinions, clinical guidance, and care coordination. Services may be provided to individuals within the United States and internationally.These services are advisory in nature and may include review of medical records, imaging, and clinical data.
3. INFORMATION WE COLLECTWe may collect the following categories of information:3.1 Personal InformationName, date of birth, and contact detailsPhone number and email addressBilling or payment information (if applicable)3.2 Health InformationMedical history, diagnostic reports, imaging, laboratory resultsInformation voluntarily submitted for consultation purposes3.3 Technical InformationIP address, browser type, device informationWebsite usage data, cookies, and analytics
4. HOW WE USE INFORMATIONWe use collected information for the following purposes:To provide telehealth consultations and second opinionsTo communicate regarding appointments, follow-ups, and care coordinationTo respond to inquiries and provide supportTo improve our website, services, and user experienceTo comply with legal and regulatory obligations5. SMS COMMUNICATIONS (TCR / A2P 10DLC COMPLIANCE)By providing your mobile phone number and opting in, you consent to receive SMS communications from Zulqarnain MD PC.
5.1 Types of MessagesAppointment remindersConsultation updatesCare coordination messagesCustomer support communications5.2 Message FrequencyMessage frequency may vary depending on your interaction with services.5.3 FeesMessage and data rates may apply based on your mobile carrier plan.5.4 Opt-OutYou may opt out at any time by replying:STOP to unsubscribeHELP for assistance5.5 Carrier DisclaimerSMS delivery is not guaranteed and may be subject to carrier limitations. Zulqarnain MD PC is not responsible for delayed or undelivered messages.
6. DISCLOSURE OF INFORMATIONWe do not sell or rent personal information.We may disclose information:To healthcare providers involved in your careTo service providers assisting in operations (under confidentiality agreements)When required by law, court order, or regulatory authorityTo protect rights, safety, or property
7. DATA SECURITYWe implement administrative, technical, and physical safeguards to protect personal and health information consistent with applicable standards, including HIPAA, where applicable.However, no system can guarantee absolute security.
8. YOUR RIGHTS AND CHOICESYou may:Request access to your personal informationRequest correction of inaccurate informationRequest deletion of your information (subject to legal requirements)Withdraw consent for communicationsRequests may be submitted to: [Insert Email]9. COOKIES AND TRACKING TECHNOLOGIESOur website may use cookies and similar technologies to enhance user experience and analyze usage. You may control cookie preferences through your browser settings.
10. THIRD-PARTY SERVICES We do not share information with third party websites.
11. MEDICAL DISCLAIMERAll information and services provided are for consultation and educational purposes only and do not replace in-person medical evaluation, diagnosis, or treatment.If you are experiencing a medical emergency, call 911 or seek immediate care.
12. NO AUTOMATIC PHYSICIAN-PATIENT RELATIONSHIPUse of this website or submission of information does not establish a physician-patient relationship unless explicitly agreed upon through a formal consultation process.
13. TELEHEALTH LIMITATIONSTelehealth services may be limited by:State and national licensing requirementsClinical appropriatenessTechnology limitationsCertain services may not be available in all jurisdictions.
14. INTERNATIONAL PATIENTSZulqarnain MD PC may provide guidance to international patients and assist with coordination for care in the United States. However:Admission decisions are made solely by receiving institutionsWe do not guarantee acceptance or treatment outcomes
15. USER RESPONSIBILITIESUsers agree to:Provide accurate and complete informationUse the website and services lawfullyNot misuse or attempt unauthorized access to systems
16. INTELLECTUAL PROPERTYAll content on this website, including text, graphics, logos, and materials, is the property of Zulqarnain MD PC and is protected by applicable intellectual property laws
17. LIMITATION OF LIABILITYTo the fullest extent permitted by law, Zulqarnain MD PC shall not be liable for any indirect, incidental, consequential, or punitive damages arising from use of this website or services.
18. INDEMNIFICATIONYou agree to indemnify and hold harmless Zulqarnain MD PC from any claims, damages, or expenses arising from your use of the website or violation of these terms.
19. GOVERNING LAWThese terms shall be governed by and construed in accordance with the laws of the State of Alabama, United States.
20. CHANGES TO THIS POLICYWe reserve the right to update this document at any time. Updates will be posted on this page with a revised effective date.
21. CONTACT INFORMATIONZulqarnain MD PC[Insert Address][Insert Email][Insert Phone Number]
22. SMS CONSENT STATEMENT (FOR WEBSITE FORM)By providing your phone number, you agree to receive SMS messages from Zulqarnain MD PC related to consultations, appointments, and care coordination. Message and data rates may apply. Reply STOP to opt out.

Notice of Privacy Practices (NPP)
Telehealth Informed Consent
Patient Agreement & Financial Responsibility
Medical Disclaimer & Second Opinion Acknowledgment
International Patient & Transfer Coordination Disclaimer
Liability Waiver & Indemnification
Acknowledgment & Signature Section
NOTICE OF PRIVACY PRACTICES (NPP)
Zulqarnain MD PC

Effective Date: May 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY
BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Zulqarnain MD PC is required by law to maintain the privacy
of your protected health information (PHI) and to provide you with this notice
of our legal duties and privacy practices in accordance with the HIPAA.
We may use and disclose your health information for
treatment, payment, and healthcare operations. This includes providing
consultation, reviewing medical records, communicating with other healthcare
providers, and coordinating care.
We may also disclose information when required by law, for
public health activities, health oversight, judicial proceedings, or to prevent
serious threats to health or safety.
We will not use or disclose your information for marketing
purposes without your written authorization.
You have the right to access, inspect, and obtain a copy of
your health information; request corrections; request restrictions on certain
uses; request confidential communications; and receive an accounting of
disclosures.
We are required to notify you in the event of a breach of
your unsecured health information.
We reserve the right to change this notice and make the
revised notice effective for all information we maintain.
For questions or complaints, contact: [Insert Email/Phone].
You may also file a complaint with the U.S. Department of Health and Human
Services.
TELEHEALTH INFORMED CONSENT
I understand that telehealth involves the use of electronic
communications to enable healthcare providers to share medical information for the purpose of improving patient care.
I understand that:
Telehealth is not a substitute for in-person care in all
situations
Technical issues may occur that could delay or disrupt
services
My information may be transmitted electronically and carries
inherent risks
I consent to the use of telehealth for consultation, second
opinion, and care coordination services provided by Zulqarnain MD PC.
I understand that:
I may withdraw consent at any time
I may refuse telehealth services and seek in-person care
Clinical decisions may be limited by the information
provided
PATIENT AGREEMENT & FINANCIAL RESPONSIBILITY
I agree to provide accurate and complete medical and
personal information.
I understand that services provided may not be covered by
insurance and may be self-pay unless otherwise specified.
I agree to pay all applicable fees associated with
consultation services.
I understand that fees are for professional consultation
services and do not guarantee specific outcomes.
MEDICAL DISCLAIMER & SECOND OPINION ACKNOWLEDGMENT
I understand that services provided by Zulqarnain MD PC are
consultative in nature and may include second opinions based on information
provided.
These services do not replace the relationship with my
primary treating physician.
I understand that clinical recommendations are based on
available data and may change with additional information or in-person
evaluation.
INTERNATIONAL PATIENT & TRANSFER DISCLAIMER
I understand that for international consultations:
Zulqarnain MD PC may provide guidance regarding care in the
United States
No guarantee is made regarding acceptance into any hospital
or healthcare system
Final decisions are made by receiving institutions
I understand that travel, admission, and treatment logistics
are subject to external factors beyond the control of Zulqarnain MD PC.
LIABILITY WAIVER & INDEMNIFICATION
To the fullest extent permitted by law, I agree that
Zulqarnain MD PC shall not be liable for any indirect, incidental, or
consequential damages arising from the use of telehealth services or reliance
on consultation recommendations.
I agree to indemnify and hold harmless Zulqarnain MD PC from
any claims arising from:
Incomplete or inaccurate information provided by me
Failure to follow medical advice
Independent decisions made outside the consultation
SMS COMMUNICATION CONSENT
I consent to receive SMS messages related to appointments,
consultations, and care coordination.
Message frequency may vary. Message and data rates may
apply.
I understand I may opt out at any time by replying STOP.
ACKNOWLEDGMENT AND SIGNATURE
I acknowledge that I have read and understand the Notice of
Privacy Practices, Telehealth Consent, Patient Agreement, and Liability Waiver.
I understand the risks, benefits, and limitations of
telehealth services.
I voluntarily consent to receive services from Zulqarnain MD
PC.

Patient Name: __________________________

Signature: __________________________

Date: __________________________