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How to prepare your child for a video visit: a parents' guide

To prepare your child for a video visit, have your photo ID, your child's recent weight, a thermometer and a list of their medicines ready, and find a well-lit spot with a stable connection. We see children from 6 months old, and a parent with patria potestad (parental authority) or a legal guardian must be on camera for the whole visit. Visits are not recorded.

Can we help by telehealth? Yes, we can help by telehealth.

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

  • A baby under 3 months with 100.4 °F (38.0 °C) or higher
  • Working hard to breathe, the chest pulling in, grunting or bluish lips
  • A seizure, a stiff neck, or being very hard to wake
  • Spots on the skin that do not fade when pressed, with a fever
  • Signs of severe dehydration: barely peeing, sunken eyes, cold hands

Help lines:

Warning signs: when to go to the ER

Book a visit

How to prepare your child before the video visit

Get these together ahead of time:

  • Your photo ID. You will show it on camera at the start. If you are a legal guardian, have the guardianship court order handy.
  • Signed consent. For patients under 21, a parent with patria potestad or a legal guardian signs the written consent before the visit.
  • Your child's recent weight. Children's medicine doses are worked out by weight. If you do not know it, weigh your child at home beforehand.
  • A digital thermometer and the temperatures you have written down, with times.
  • The medicines your child takes or has had in the last few days, with doses. Keep the bottles nearby.
  • A flashlight or phone light to help show the throat.
  • The physical address where you are in Puerto Rico during the visit, in case help ever needs to be sent.

Your device: computer or phone

On a computer the visit runs in your browser with nothing to download. On a phone or tablet you need the free "Telehealth by SimplePractice" app, so install it beforehand. The portal can be shown in Spanish on the web; some forms and the app are in English. Charge your device and pick a spot with a good internet signal. See how a visit works.

How to check temperature and count breaths

Use a digital thermometer, never a mercury one. Forehead thermometers work at any age, ear thermometers from 6 months, and oral readings only from age 4. A fever is 100.4 °F (38.0 °C) or higher.

To count breaths, wait until your child is calm or asleep, lift their shirt and count how many times the chest rises in one full minute. Also notice whether the skin pulls in between the ribs or the nostrils flare with each breath. Write the number down for the doctor.

How to show the throat, ears and skin on camera

A few tips so the doctor can see clearly:

  • Light: face a window or use a lamp. Natural light is best.
  • Throat: ask your child to open wide and say "aah", and shine a flashlight or a second phone's light into the mouth.
  • Skin: bring the camera close to the rash, then pull back to show the whole area.
  • Ears: the doctor can see swelling or drainage on the outside, but cannot see the eardrum by video, so she cannot confirm an ear infection. Read ear pain in children.
  • Private areas: the doctor will tell you what to show, only if needed, and you are present the whole time.
  • Do not send photos of your child by WhatsApp or email.

During the visit: you stay for the whole visit

A parent with patria potestad or a legal guardian stays on camera for the entire visit and shows photo ID at the start. For now we do not accept another adult, such as a grandparent or nanny, in your place. If the guardian check cannot be completed, the visit does not go ahead and you get a full refund.

If your child is old enough, let them tell the doctor how they feel. The doctor is a general practice physician and is not a pediatrician: she treats common problems and will tell you when an in-person visit or a pediatric specialist is needed. Visits are not recorded.

What we cannot do by video for children

Some things need an in-person visit. See also what we don't do by telehealth and school health forms.

  • Emergencies
  • Confirming ear infections
  • Strep tests
  • Urine tests for young children
  • Vaccines and the PVAC-3 (hoja verde) vaccination certificate
  • The certificado de salud and school, daycare or sports physicals
  • Well-child checks
  • Babies under 6 months

After the visit

If appropriate, the doctor can prescribe medication, with the dose worked out from your child's weight. We do not prescribe controlled substances. If your child has a regular doctor, let them know about the visit so their records stay complete.

If your child gets worse after the visit or a warning sign appears, do not wait: call 911 or go to the ER, day or night. Read also cough and cold in children.

Before you log on: warning signs by age

If your child has any of these signs, do not wait for a video visit: call 911 or go to the ER. We do not see babies under 6 months, and a baby under 3 months with a temperature of 100.4 °F (38.0 °C) or higher needs the ER. There is more detail in fever in children.

  • 6 to 12 months: a weak, high-pitched or nonstop cry; a bulging soft spot; green or bloody vomit; can't keep fluids down; fewer than 6 wet diapers a day and very sleepy.
  • 1 to 5 years: noisy, high-pitched breathing at rest; drooling or unable to swallow; peeing only once or twice a day, with sunken eyes and cold hands.
  • 6 to 17 years: a severe headache with a stiff neck; chest pain or fainting during exercise; severe pain low on the right side of the belly; testicular pain; shortness of breath in a child with asthma despite the inhaler; thoughts of self-harm (call 988 or Línea PAS).
  • At any age: a seizure, a stiff neck, being very hard to wake, working hard to breathe or bluish lips, or spots that do not fade when pressed, with a fever.

When you are ready to book

An online doctor visit for kids costs US$79, the same as for an adult, and you pay by card when you request it. If the visit can't take place, you get a full refund. Request a visit online 24/7 — we confirm your time by email or text. Adults in the family can book an online doctor visit too.

If the connection drops

Rejoin using the same visit link. Meanwhile, keep your child close and your device charged. If the connection drops while your child has a warning sign, do not wait to reconnect: call 911.

Video visit: US$79 · Pay by card · See the price and what is included

Before you book

  • You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
  • We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
  • Real-time video only; we do not do phone-call visits.
  • We do not prescribe controlled substances.

What we don't do by telehealth

Frequently asked questions

Do I have to be there for my child's video visit?
Yes. For patients under 21, a parent with patria potestad or a legal guardian signs the consent, stays on camera for the whole visit and shows photo ID.
Can a grandparent or another relative handle the visit?
Not for now. Only a parent with patria potestad or a legal guardian can be in charge of the visit for a patient under 21.
From what age do you see children by video?
From 6 months. Babies under 6 months need in-person care, and a baby under 3 months with a fever needs the ER.
Why do you ask for my child's weight?
Because children's medicine doses, including fever medicines, are worked out by weight. A recent weight helps keep the dose safe.

Sources

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