Welcome to Ace Veteran Medical Consulting!

Intake Acknowledgment and Consent

By submitting this intake form, you acknowledge and agree to the following:

1. No Treating Provider Relationship
   Submission of this form and any supporting documentation does not establish a treating provider–patient relationship. Ace Veteran Medical Consulting, LLC provides independent medical record review and written medical opinion services only and does not provide medical treatment, diagnosis, or ongoing care.
    
2. No VA Representation
   Ace Veteran Medical Consulting, LLC does not prepare, file, or represent veterans in VA disability claims and is not affiliated with the U.S. Department of Veterans Affairs. Submission of this form does not create any legal representation or agency relationship.
    
3. No Guarantee of Acceptance or Outcome
   Completion of this intake form does not guarantee acceptance of your case or the issuance of a medical opinion. Any review is preliminary and subject to further evaluation and a signed service agreement.
    
4. Consent to Collection and Review of Records
   You voluntarily consent to the collection, secure transmission, and review of medical records, service records, and personal information that you submit or that you may later provide upon request for the purpose of evaluating and potentially providing medical consulting services.
    
5. Accuracy of Information
   You affirm that the information and records provided are accurate, complete, and truthful to the best of your knowledge. Providing false or misleading information may result in denial of services.
    
6. Privacy and Data Handling
   Information submitted through this intake form will be handled in accordance with our Privacy Policy and applicable federal and state laws governing the protection of personal and health information.
    
7. Pre-Engagement Status
   No services will be rendered, and no professional opinion will be issued, until a separate written service agreement is executed and applicable fees are arranged.