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We have technology in place to perform remote face-to-face encounters through internet video and audio. Our telemedicine exam room has been equipped with HIPPA compliant high resolution audio/video, and employs a remote controllable pan/tilt camera. These visits begin with a patient completing pre-visit paper work, having vital signs taking and having a preliminary assessment done by nursing personnel. Applicable laws are such that a remote office visit is deemed to have taken place where the patient (not the provider) is located. This type of remote encounter may be necessary in some instances in conducting follow-up visits for established patients.