I was hesitant about the whole skype thing, but it was basically the same as going to the office. Input your info, put in your payment info and the doctor sees you according the order you're signed up in. I spent about the same amount of time with doctor as I spent with my previous doctor at his office, but it was a skype call instead of a face-to-face. The email rec works for deliveries and the stamped rec is sent standard mail (or a rush-mail for an additional charge). Highly recommend.