Guides
How to prepare your child for a video visit: a parents' guide
To prepare your child for a video visit, have your photo ID, your child's recent weight, a thermometer and a list of their medicines ready, and find a well-lit spot with a good signal. We see children of all ages, from babies to teens. For patients under 21, a parent with patria potestad (parental authority) or a legal guardian stays on camera for the whole visit. Visits are not recorded.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- A baby under 3 months with 100.4 °F (38.0 °C) or higher
- Working hard to breathe, the chest pulling in, grunting or bluish lips
- A seizure, a stiff neck, or being very hard to wake
- Spots on the skin that do not fade when pressed, with a fever
- Signs of severe dehydration: barely peeing, sunken eyes, cold hands
Help lines
How to prepare your child for a video visit: what to have ready
Get these together ahead of time:
- Your photo ID. You show it on camera at the start. If you are a legal guardian, have the guardianship court order handy.
- Signed consent. For patients under 21, a parent with patria potestad or a legal guardian signs the written consent before the visit.
- Your child's recent weight. Children's medicine doses are worked out by weight. If you don't know it, weigh your child at home beforehand.
- A digital thermometer and the temperatures you have written down, with times.
- The medicines your child takes or has had in the last few days, with doses. Keep the bottles nearby.
- A flashlight or a second phone's light to help show the throat.
- Your pharmacy's name, in case the doctor prescribes something.
- The physical address where you are in Puerto Rico during the visit, in case help ever needs to be sent.
How a child's video visit works
Dr. Diana Nieves Castro is a general practice physician licensed in Puerto Rico, with several years of emergency-department experience. She sees adults and children of all ages, in English or Spanish. We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you. See how it works.
- Request a visit and pay by card. Choose the doctor visit. Request a visit online 24/7 — we confirm your time by email or text.
- Join with your child. We send you a secure video link. It works on your phone, tablet or computer. You need to be physically in Puerto Rico; visiting families are welcome.
- The doctor assesses your child. If appropriate, the doctor prescribes and we send your prescription to your pharmacy, dosed by weight. If a test such as a strep or urine test is needed, you get a lab order for a lab near you.
What it costs
An online doctor visit for kids is the US$79 doctor visit, the same for every age, with no membership. A doctor's note for school or daycare after the visit is included. You pay by card when you request it, with a full refund if the visit can't take place. See pricing. The service is run by The Health Initiative, a nonprofit.
How to check temperature and count breaths
Use a digital thermometer, never a mercury one. Forehead thermometers work at any age, ear thermometers from 6 months, and oral readings only from age 4. A fever is 100.4 °F (38.0 °C) or higher.
To count breaths, wait until your child is calm or asleep, lift their shirt and count how many times the chest rises in one full minute. Also notice whether the skin pulls in between the ribs or the nostrils flare with each breath. Write the number down for the doctor.
How to show the throat, ears and skin on camera
A few tips so the doctor can see clearly:
- Light: face a window or use a lamp. Natural light is best.
- Throat: ask your child to open wide and say "aah", and shine a light into the mouth.
- Ears: the doctor guides you to show the ear and asks about pain, fever and any drainage. Read ear pain in children.
- Skin: bring the camera close to the rash, then pull back to show the whole area.
- Private areas: the doctor tells you what to show, only if needed, and you are there the whole time.
- Do not send photos of your child by WhatsApp or email.
During the visit: you stay for the whole visit
For patients under 21, a parent with patria potestad or a legal guardian stays on camera for the entire visit and shows photo ID at the start. That includes 18- to 20-year-olds, because the age of majority in Puerto Rico is 21. For now we do not accept another adult, such as a grandparent or nanny, in your place. If the guardian check cannot be completed, the visit does not go ahead and you get a full refund.
If your child is old enough, let them tell the doctor how they feel. Visits are not recorded.
After the visit
If appropriate, the doctor prescribes with the dose worked out from your child's weight, and we send your prescription to your pharmacy. We do not prescribe controlled substances. If you got a lab order, take it to a lab near you; reviewing the results is a follow-up visit.
If your child gets worse or a warning sign appears, do not wait: call 911 or go to the ER, day or night. Read also fever in children, cough in children, rash in children and diarrhea and vomiting in children.
Before you log on: warning signs by age
For your child's safety, if they have any of these signs, do not wait for a video visit: call 911 or go to the ER. A baby under 3 months with a temperature of 100.4 °F (38.0 °C) or higher needs the ER.
- Babies under 1 year: a weak, high-pitched or nonstop cry; a bulging soft spot; green or bloody vomit; can't keep fluids down; fewer than 6 wet diapers a day and very sleepy.
- 1 to 5 years: noisy, high-pitched breathing at rest; drooling or unable to swallow; peeing only once or twice a day, with sunken eyes and cold hands.
- 6 years and up: a severe headache with a stiff neck; chest pain or fainting during exercise; severe pain low on the right side of the belly; testicular pain; shortness of breath in a child with asthma despite the inhaler; thoughts of self-harm (call 988 or Línea PAS).
- At any age: a seizure, a stiff neck, being very hard to wake, working hard to breathe or bluish lips, or spots that do not fade when pressed, with a fever.
If the connection drops
Rejoin using the same visit link. Meanwhile, keep your child close and your device charged. If the connection drops while your child has a warning sign, do not wait to reconnect: call 911.
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. We do not prescribe controlled substances.
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 I have to be there for my child's video visit?
Can a grandparent or another relative handle the visit?
What ages do you see by video?
Why do you ask for my child's weight?
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: 2026-10-02
Sources (5)
- How to take a child's temperature (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-09-30)
- Fever in under 5s, NG143 (NICE) (opens in a new tab) (accessed 2026-09-29)
- Nonemergency acute care delivered outside of the medical home, policy statement (AAP, Pediatrics 2026) (opens in a new tab) (accessed 2026-09-29)
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018 (LexJuris, Spanish) (opens in a new tab) (accessed 2026-09-29)
- Telehealth Regulation 9518 (Puerto Rico Department of Health, Spanish) (opens in a new tab) (accessed 2026-09-29)