What we don’t do
What we don't do by telehealth: when to go in person
What we don't do by telehealth is a short list: emergencies (call 911), the Puerto Rico health certificate (we do not issue it; an authorized doctor does in person), and exams that need hands-on contact. Almost everything else, the doctor evaluates, diagnoses and treats by video for adults and children of all ages: she prescribes if appropriate and gives you lab orders.
What we do not handle by video
Emergencies: call 911
Emergencies: call 911
If you have chest pain, trouble breathing, stroke signs, bleeding that won't stop or another warning sign, call 911 or go to the nearest emergency room. For problems that aren't emergencies but can't wait, there is virtual urgent care: video visits any time. See when to go to the ER.
Medicines and weight management: the doctor decides what is appropriate
If appropriate, the doctor prescribes and we send your prescription to your pharmacy, including refills of medicines you already take (non-controlled). For any medicine, the doctor decides during the visit which treatment is appropriate and safe, under federal and Puerto Rico law; we never promise a specific medicine. We also help you lose weight with an evaluation, labs and, if the doctor considers it appropriate, a medicine such as Wegovy or Zepbound. For weight loss we prescribe only FDA-approved medicines; the clinic does not offer compounded semaglutide or tirzepatide. Read about brand semaglutide.
What we don't do by telehealth: documents with an in-person step
Some documents legally require something done in person:
- Certificado de salud (health certificate): a doctor authorized by the Department of Health issues it in person, and the TB skin test is placed and read in person. Our clinic does not issue the health certificate for employment. By video, we do see you in a doctor visit and give a doctor's note after your evaluation. More in the health certificate guide.
- Evaluations or certificates to start a job (health card, food handler): we do not issue them. The health certificate guide explains who does.
- Vaccines and the vaccination certificate ([PVAC-3](route:guide-pvac3)): given and recorded in person. See the school certificates guide.
- Forms that need a vision exam, such as the driver's license form. See the driver's license certificate guide.
Is this an emergency?
Call 911 or go to the nearest emergency room for chest pain, trouble breathing, weakness or numbness on one side of the body, confusion, bleeding that will not stop, or if you think your life is in danger.
Help lines
What we do
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Do you prescribe controlled medicines?
Do you see children by video?
Can you do the health certificate by video?
What can't be done by telehealth?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-11