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BASELINEEND-OF-LIFE CONSULTATIONS

Preliminary inquiry pathway

Patient & Family Intake

A careful first step for people considering an independent consulting-physician evaluation in New York.

Do not enter or send medical information through this public website. The anonymous self-check below does not collect, store, or transmit your answers.

Private, browser-only screening aid

Preliminary self-check

This anonymous self-check can help you decide whether requesting a consultation may be appropriate. Your answers remain in your browser and are not sent to Baseline or stored by this website. This is not a medical determination, a statutory request for medical aid in dying, or the establishment of a physician-patient relationship.

1. Are you 18 years of age or older?
2. Are you a resident of New York State?
3. Are you currently working with a physician who is willing to serve as the attending physician for your medical-aid-in-dying request?
4. Have you been told by a treating clinician that you have an incurable and irreversible illness expected to result in death within six months?
5. Can you participate in a private, live audiovisual consultation while physically located in New York State?

What happens next

A staged, secure process.

1

Pending request

If the self-check indicates that a preliminary inquiry may be appropriate, use the secure intake form. The date and time selected there remain subject to staff review.

2

Administrative review

Baseline reviews fit, timing, and capacity. Acceptance for clinical review is not guaranteed.

3

Secure portal after acceptance

If accepted, the secure patient portal supports detailed questionnaires, consents, e-signatures, and requested medical-record uploads.

4

Scheduling and care

The secure patient portal supports scheduling and clinical documentation before any live audiovisual evaluation.

Fees

Transparent self-pay structure.

$850 standard evaluation

$250 initial clinical record review, credited toward the total.

$600 balance due before the live evaluation.

Up to $1,000 for complex or time-sensitive cases

Any adjusted fee is disclosed in advance. Limited reduced-fee and pro bono availability may be offered.

Payment, review, and consultation do not guarantee eligibility. The consulting physician does not prescribe medication through this service.

Safety notice

This service does not provide emergency or crisis care. If you are in immediate danger or considering harming yourself outside the medical-aid-in-dying process, call 911 or 988.
Baseline End-of-Life Consultations

A distinct service sub-brand operated through Baseline Sports Performance Medicine, PLLC. It is not represented as a registered assumed name.

General information only.