ClaraMed™ — Physician Network Application

Section 1 of 6

Personal information

Please confirm your invitation details first, then complete your personal and professional information. All information is treated with strict confidentiality and used only for physician network vetting.

Invitation Only · Founding Circle

You have been personally invited to apply to the ClaraMed physician network.

Physicians cannot self-enroll. Every physician in the ClaraMed network was personally introduced through peer relationships. If you have not received a personal invitation, please contact physicians@claramed.us before proceeding.

Before we begin — your introduction

Who personally invited you to apply? *

Name of the physician, colleague, or ClaraMed team member who introduced you

Your relationship with them *

Academic validation

ClaraMed's model is independently validated by peer-reviewed research presented at the 31st International HPH Conference 2026, Slagthuset, Malmö, Sweden (May 20–22, 2026) — confirming that AI-enabled specialist consultation transforms distance into access, delivering modern medicine equitably across borders.

First name *

Last name *

Professional email address * Institutional email preferred

Mobile phone * Include country code

Current primary institution / hospital *

City and country *

LinkedIn profile or institutional profile URL Optional but helpful

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Credentials & qualifications

Your medical education, board certifications, and current clinical standing. ClaraMed verifies all credentials independently before onboarding.

Medical degree *

Medical school and graduation year *

Postgraduate training

Residency program and specialty *

Fellowship training List all; leave blank if not applicable

Board certification

Primary board certification *

Additional board certifications Optional

Current state / country medical license number(s) *

NPI number US physicians — National Provider Identifier

Academic and clinical standing

Current academic title *

Are you currently in active clinical practice? *

Yes — full-time clinical practice

Yes — part-time clinical practice

Primarily research — some clinical practice

Retired from clinical practice

Do you currently hold valid malpractice insurance? *

Yes — institutional coverage through my hospital or institution

Yes — personal malpractice insurance policy

No — retired or academic position without clinical coverage

Unsure — I would like guidance on this

Have you ever had a medical license suspended, revoked, or been subject to disciplinary action? *

No

Yes — I will provide details to ClaraMed directly

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Clinical experience & subspecialty

Your subspecialty focus, years of practice, and the types of cases you are best positioned to review for international patients.

Primary subspecialty *

Secondary subspecialty or areas of additional expertise Optional

Total years in clinical practice *

Approximate annual case volume in your subspecialty *

Case review experience

Have you previously provided formal second opinions or expert consultations? *

Yes — regularly, as part of my clinical practice

Yes — occasionally, on request

Yes — through another formal second opinion platform

No — this would be my first formal second opinion service

Have you reviewed cases involving international patients? *

Yes — frequently

Yes — occasionally

Rarely or never

Academic & research profile

PubMed / Google Scholar profile URL Optional but strongly encouraged

Approximate number of peer-reviewed publications Optional

Professional society memberships Optional — list major ones

Notable awards, named lectures, or leadership roles Optional

Please describe your particular clinical expertise and the types of complex cases where your opinion would be most valuable *

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Languages & cultural background

ClaraMed serves patients across the Gulf, Southeast Asia, Latin America, and Africa. Physicians who can communicate directly with patients in their language create a fundamentally different level of trust. This is one of our most valued network attributes.

Language capability is a significant differentiator in our network. Even conversational proficiency in a patient's language — beyond English — is highly valued and will influence case matching.

Languages you speak — select all that apply and rate your proficiency *

🇸🇦

Arabic

Gulf · Middle East · North Africa

🇮🇳

Hindi / South Asian languages

India · Pakistan · Bangladesh · Sri Lanka

🇨🇳

Mandarin / Cantonese

China · Taiwan · Singapore · Malaysia

🇧🇷

Portuguese

Brazil · Portugal · Lusophone Africa

🇲🇽

Spanish

Latin America · Spain · US Hispanic

🇫🇷

French

Francophone Africa · France · Canada

Other languages not listed above Optional

Cultural background or heritage that may be relevant to patient matching Optional — helps us match patients appropriately

Have you lived or practiced medicine outside the United States? *

Yes — for an extended period (2 or more years)

Yes — briefly, for training or research

No — trained and practiced in the US throughout

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Availability, motivation & compensation

Your capacity to review cases, preferred working style, and what motivates you to join ClaraMed. This helps us match case volume appropriately from the start.

How many cases per month are you comfortable reviewing? *

1–2 cases per month Starting pace — suitable for trying the platform

3–5 cases per month Moderate pace — most common among network physicians

6–10 cases per month Higher volume — for physicians with dedicated time

More than 10 cases per month Please contact us to discuss

Typical turnaround time you can commit to *

3–5 business days Priority tier — enables our Premium service

5–7 business days Standard and Comprehensive tier

7–10 business days For complex multi-record cases

Depends on the case — I would like to assess each request individually

How many hours do you estimate per case for record review and written opinion? *

1–2 hours for straightforward cases in my core subspecialty

2–4 hours for most cases including complex multi-record reviews

4–6 hours for the most complex diagnostic challenges

Compensation preferences

Physician compensation model preference *

Per-case fee — 55% of patient case fee (1099 independent contractor — no minimum case volume commitment) ($1,375–$2,750 per case depending on service level) Most common — paid within 7 business days of case completion

Equity participation — advisory role with platform equity For physicians interested in a longer-term advisory relationship

Combination of per-case fee and equity I am open to discussing a hybrid arrangement

Would you be interested in an advisory board role? *

Yes — very interested in helping shape ClaraMed's clinical direction

Possibly — would like to know more about the commitment involved

No — I prefer to participate through case reviews only

Motivation & fit

What motivates you to join the ClaraMed physician network? * Select all that apply

Access to complex, interesting cases from international patients in my subspecialty

Mission — I believe expert medical opinion should be accessible regardless of geography

Supplemental professional income alongside my primary practice

Connecting my expertise with patient populations who cannot access top US care

Interest in the platform's growth and advisory equity opportunity

My colleague's introduction — I trust their judgment in recommending this

Is there anything else you would like our team to know before your introductory conversation? Optional

How did you hear about ClaraMed? *

By submitting this form you confirm that the information provided is accurate and complete to the best of your knowledge. ClaraMed will independently verify all credentials before any case assignment. Submission does not constitute an offer of engagement.

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Review & submit

Please review your responses before submitting. Our team will personally review your application and reach out within 3 business days to schedule a 20-minute introductory conversation.

What happens next: Our team will personally review your application and contact you at the email address provided within 3 business days. If your application progresses, the next step is a 20-minute introductory conversation — no commitment required at that stage.