Lung cancer treatment in 191 Oncology and Thoracic surgery clinics in Americas

man haha if you ever need to get surgery all of the sudden while completely tripping balls, it wont be the funnest experience of your life or anything but at least my nearly severed limbs work again 1500$ later. thanks docs and nurses!

The Intensive Care staff brought me back to life. Dr. Sanchez is a miracle worker. The staffing were so thorough and attentive. A+ rating.

I would not go to this hospital under any circumstances, especially if you are a foreigner and the hospital may have the impression that you have money. There are better hospitals where you are more likely to be treated humanely and fairly, such as Catholica Hospital. My father went into Clinica Biblica to be treated for dehydration, and within a week he was in a coma and had a stroke. I believe wholeheartedly that several members of their medical staff prolonged an agonizing course of surgeries and treatments simply in order to make a profit off of a dying man. It was heart wrenching and traumatizing. I wanted desperately to move him to a public hospital where his health insurance would cover the costs, and Biblica would not release him, causing our medical bills to increase dramatically by the day. Ultimately, my father did not make it, and the hospital would never explain what happened. Why was he admitted to be treated for dehydration and ended up on his death bed. Also, you should know that Costa Rican people are generally some of the best, kindest people on the planet, however, there is a machismo that is inescapable. The male doctors spoke down to my sisters and I in the most awfully condescending way I have ever experienced. If you have a serious medical issue, I implore you - go anywhere else but here. They are all about money and will take advantage of your need for care. Beware.

Bad Experience I had an unfortunate experience when I accompanied my boyfriend to the emergency room. Upon our arrival, I couldn't help but notice that the staff at the cashier's desk were engrossed in conversations about their personal lives, as if they were attending a social gathering rather than attending to the needs of the waiting patients, many of whom were feeling unwell. This lack of professionalism was disheartening. Subsequently, we proceeded to the consultation, hoping for a resolution to my boyfriend's health issue. Unfortunately, not only did they fail to address the problem effectively, but they also took an extensive amount of time dealing with the paperwork related to our health insurance. This bureaucratic delay was frustrating, especially considering that my boyfriend was still feeling terrible after over an hour of waiting. To make matters worse, we were unexpectedly presented with a bill amounting to nearly 400 dollars. Given the exorbitant cost, we were disheartened to realize that we still had no concrete diagnosis. The doctor merely provided us with the name of a specialist, leaving us feeling dissatisfied with the level of care provided. It is disheartening to conclude that this hospital seems to prioritize profit over patient well-being.

Private hospital, hete you can find all medical specialties prices range between $85 to $120 for dovtor visit. ER visit costs under $100. The hospital has all types of diagnostics equipment.

I visited the emergency room. It was my first time at CIMA. I was seen quickly and received thorough testing and care. All of the staff were kind and patient. They were even kind with my limited Spanish and never made me feel bad for not speaking Spanish well. The ER doctor was especially kind, listened well, and explained his thoughts and reasoning thoroughly. He was also patient when i struggled to remember medical history in the moment. He was easily one of the best doctors I have ever seen. All of the staff was wonderful.

Huge hospital with many specialties, including non-invasive cardiology, urology, oncology, orthopedics, among others. It is well located in the city of São Paulo, close to Vergueiro station. There are two other hospitals close by, including the BP hospital.

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I have been here several times, but today seems to be the time that this hospital's ER is the least prepared. Having passed through covid season peak now the hospital seems not being able to cope with the current influenza surge. The expected waiting time for a clinic evaluation, not considering possible needed exams or medications is of 4 hours! Seems that there is no medical staff at all right now. However the nursing and administrative staff are whatever possible. Hope somehow they can cope better with this seasonal flu...

I was at the Oswaldo Cruz Vergueiro unit on 11/24/23 at 8 pm. The service was for my mother and it was reasonable, however I witnessed the arrival of a girl with an injury to her head. The family in panic with the girl on their lap. The security guard and triage nurse were so quick that I didn't even see where they came from. The medical team was also quick and I saw the stabilized girl being taken to the upper floors. Of all this, what caused surprise was the apathy of the receptionists. They didn't help at all. Not even the family seeing the issue of documents to open the file. Even the nurse on duty was irritated with the receptionists. There was a lack of empathy, there was a lack of humanity in the service. Reception grade zero. Security and medical team, grade 1000

This hospital it’s unclean and the service are very bad we was waiting over 8 hours just to see the doctor

Hospital increasingly abandoned. Bad mood from reception to service floor. Doctor, thank God, he treats me well. Dr Alexander. So abandoned that there's no one to even pick up the token... 🤦🏻 (3rd floor) Sadly.

It is an excellent hospital, well located and with a wonderful team. We are always very well attended to, they give us quick solutions with zero bureaucracy. I have been a patient for 4 years and the service is always of the same standard. Whenever I feel something or go straight to this hospital 🏥. It has a restaurant, cafes, 24-hour bank and valet.

Considered top level. The prompt service leaves a lot to be desired. I passed on 25/Nov/23. In pain, the medical team only did a urine test. When the doctor came to talk, she had to consult a urologist with my request for medication, as I was in pain. In short, an US or CT scan would solve the problem and be accurate. But I had to go to another hospital to find out. BP Mirante for emergency care is too weak.

IS A PREMIUM?!?! JOKE!! Yesterday I was in the ER and I was outraged by the lack of structure and commitment to the patient. Only 1 attendant to open a form, 1 person doing the triage, 2 doctors attending all Emergency Rooms, patients being placed in common chairs to be medicated, only 1 nursing assistant to apply all the patients' medications and mismatched information. I thought that the fact that Mirante has premium service would never be served in this way. The doctor who attended to me prescribed the same medications I was taking at home, did he think I liked going to the ER for a walk? While I was in the medication room, I asked the person responsible for the PS, and nurse Bruna came to assist me. I informed him what was happening and he immediately took action. He transferred my care to a surgeon to analyze me, transferred me to a private place to receive the new prescribed medications, in short, he did everything possible to make my impression change. The problem is that I wouldn't have needed to complain to receive the service that should have been offered. I was extremely disappointed with BP Mirante, as it was not what I expected for this service.

It is an excellent hospital, well located and with a wonderful team. We are always very well attended to, they give us quick solutions with zero bureaucracy. I have been a patient for 4 years and the service is always of the same standard. Whenever I feel something or go straight to this hospital 🏥. It has a restaurant, cafes, 24-hour bank and valet.

Considered top level. The prompt service leaves a lot to be desired. I passed on 25/Nov/23. In pain, the medical team only did a urine test. When the doctor came to talk, she had to consult a urologist with my request for medication, as I was in pain. In short, an US or CT scan would solve the problem and be accurate. But I had to go to another hospital to find out. BP Mirante for emergency care is too weak.

IS A PREMIUM?!?! JOKE!! Yesterday I was in the ER and I was outraged by the lack of structure and commitment to the patient. Only 1 attendant to open a form, 1 person doing the triage, 2 doctors attending all Emergency Rooms, patients being placed in common chairs to be medicated, only 1 nursing assistant to apply all the patients' medications and mismatched information. I thought that the fact that Mirante has premium service would never be served in this way. The doctor who attended to me prescribed the same medications I was taking at home, did he think I liked going to the ER for a walk? While I was in the medication room, I asked the person responsible for the PS, and nurse Bruna came to assist me. I informed him what was happening and he immediately took action. He transferred my care to a surgeon to analyze me, transferred me to a private place to receive the new prescribed medications, in short, he did everything possible to make my impression change. The problem is that I wouldn't have needed to complain to receive the service that should have been offered. I was extremely disappointed with BP Mirante, as it was not what I expected for this service.

Terrible service, I needed to perform a procedure with anesthesia, I had to ask God and everyone for permission, and on the day of the procedure they said that it wasn't in their documents that there would have to be anesthesia. I had to do the procedure without it and it was horrible.

I had a Coronary Angiotomography on 11/28/23, excellent service since my arrival, the doorman who opened the car door for me to get out, the reception had excellent service, a 10 for the girls at the service and the interview and at the location of the exam I was very well looked after by the Nursing Team and the Doctor who carried out the exam. Mother of God Hospital Congratulations on the service, excellent.

Hospital Mãe de Deus was once a reference hospital in Porto Alegre, but it is currently in terrible condition. Nursing technicians unprepared to care for people, too long waiting times, information that exam machines - resonance, x-ray, are "damaged" (which would be a reason for delays and rescheduling of exams), structure is very bad (broken tables, beds that don't work), poor hygiene (hospital waste on the floor in the medication room, such as bloody gauze and used cotton), hospitalization schedules are not followed (meals are delivered many hours late to patients ), between others. Hospital Mãe de Deus currently leaves something to be desired and any possible inspection of minimum requirements should even be able to penalize them. Relatives of patients talk to each other there and the vast majority are perplexed by what they are doing with Hospital Mãe de Deus, which was once a reference entity. Currently, Hospital Moinhos de Vento and Complexo da Santa Casa de Porto Alegre are far ahead in every way.

Trusted hospital in Curitiba. I had surgery and their infrastructure is incredible. Everything very clean and organized, waiting rooms and apartment well equipped. The surgery was a success! Meals were served in generous portions with good flavor and temperature. My gratitude to the hospital's surgical team. I've needed their emergency care too, but the staff who go to an elective consultation instead of the emergency itself end up delaying the service (a problem more of the culture of the population than of the hospital), making the waiting time long, but later service, the professionals provide a great service. I will come back whenever I need to.

Nice one

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I went on 11/22/23 at 11pm something (I don't remember the exact time) with a fever of 40 and discomfort throughout the body, with vomiting. To which they answer that they only attend to emergencies. Only guard is from 8am to 9pm. How can it be that a public hospital has guard duty all day and night and this hospital, which is classified as the best, only has guard duty during certain hours. The person who assists me tells me after I complained that I required medical attention that they would attend to me but I would have to wait at least 4 hours, but that it was safer in 5 hours. With terrible abdominal and body pain, I waited 1 hour and a half and left, to which they wanted to charge me for parking and with a card only. I had cash. But at night it is only with the posnet and you charge yourself. I had to go to the Lomas de San Isidro, and upon seeing my condition, they treated me in 30 minutes, where they referred me to a room and made me Urgent studies and analysis. They treated me excellently. Let's see if the hospital commission understands that the patient does not have a stipulated time to feel bad. That is why it is a guard to attend at any time. I know that the word (Guard) has a certain schedule for whoever manages the hospital. I must clarify that the hour of parking is too expensive, the hour costs more than two liters of gasoline. And the car is left out in the open. Also Sometimes to pay for parking there is a long line and there is a delay when you are in the sun or rain without shelter. It should be subsidized. But the greed is greater. I must clarify that the professionals always treated me more than well in the Austral. The issue is They give you shifts with a delay of 2 months. There are never shifts.

The hospital has excellent doctors. The serious problem that this hospital has is access to medical appointments. A patient has follow-up checks for chronic medication and the SHIFT staff, after several attempts, respond that they do not have appointments for this month and do not know when they will open the agenda for the next one. I go through the application and it doesn't schedule an appointment for that doctor and it tells me to contact me by phone. And as best as you can during your work hours, you keep trying and spend the month with the Same answer 🤷‍♀️ It's an epic to get a turn. And an almost impossible challenge to achieve medical follow-up for treatment. How to solve it 🙏🏻? How many more patients are there in this same situation? A first level hospital has to be able to solve this urgent issue.

Excellent attention from everyone, from the security person at the entrance, to the receptionists as well as the doctors, who are super professional. They treated me quickly and gave me an accurate diagnosis. There were a lot of people in the waiting room, I thought I wasn't going anymore. But the service is fast, since there are many receptionists and many doctors serving at the same time. The building is beautiful, large, clean, with coffee machines (you can pay with MercadoPago) and some things for breakfast. Highly recommended.

Disgusting unprofessionalism! A child of 11 months arrived at night with a temperature of 39.6.! Doctor looked at baby throat and said it was streptococcus. I was told to do a streptococcus test, to which the doctor said absolute stupidity that it don't do for children!! And she didn't prescribe any treatment! Streptococcus needs to be treated! We have insurance in this hospital, I don't recommend it to anyone! We will leave this hospital!

I'm a traveler from the US who had a ear pain and needed to see a doctor right away. Most hospitals in the area have bad reviews so it was hard to find some healthcare for myself. Eventually I choose this hospital because people referred me here the most. Went to the emergency room but they directed me to the specalist inside the main building. After registering I needed to pay but they wouldn't accept cash over 10k pesos and i didn't have my credit card with me. So i had to go across the street for a bank deposit. After that i paid and saw the doctor immediately. So in my situation since i saw a specialist that doesnt have many patients i was in and out in about an hour. Im very satisfied with the care i recieved and how prompt everything was despite the language barrier and i dont speak much spanish so Google translate is my buddy. Id recommend this hopsital if you want to be seen faster than a public hospital and are willing to pay. This was a faster and wayyy cheaper experience than in the US. I give this 4 stars because of the bank deposit thing, but otherwise im very pleased 👌

Updating my review cause now I'm a holder of their health insurance and I'm very happy with it. The phone line sucks though, it takes ages to get an answer and then they tend to transfer you to a different department that cuts the call or never answers. It's way faster to go there and ask everything in person.

Good hospital but total inflated prices, they charge so high that they reach above the TOPE of your insurance. For a small one - hour surgery, they charge 7 million CLP

“Urgencia” doesn’t move with much urgency. I’m currently in the waiting room in the respiratory area of the emergency department. My mother in law arrived in bad condition and I saw no sign of triage or prioritization based on symptoms , first come first served. NONE of the alcohol hand dispensers have alcohol, staff aren’t using alcohol gel. Not just in the emergency area but also in the other buildings I passed through. Very surprised by the experience considering the cost and reputation of the hospital. Go to Clinica San Carlos de Apoquindo UC or Clínica Alemán.

I had a severe reaction to a Lyme disease infection contracted in the USA, that manifested itself when I arrived. I was hospitalized at Clinica Los Condes for 3 days. The care was superb. Since Lyme disease does not exist in Chile, the staff coordinated their care for me in coordination with the USA CDC.

We unfortunately had a five night stay at the NICU over the Thanksgiving holiday. The staff provided excellent care to our kid and were extremely compassionate to us as parents. We were grateful for the private sleep rooms and shower, and they even had a free Thanksgiving dinner for everyone. The parent / family lounges have places to grab coffee and store food, and everything is very clean and organized. The doctors and nurses were very communicative and kept us in the loop the entire time.

Absolute terrible service , my child who has a seizure disorder and potential c- diff was made to wait in the ER for 3 and half hours plus without even being properly triaged . She didn’t receive a wrist band , at any point & we can run the cameras back , no one was alerted to her allergies , there was no band received for that as it typically is .. and she begin to have diarrhea thru the long wait due to the virus she’s had the past week and in turn she begin to get worked up and her fever returned . I asked how much longer the wait would be abd for an approximate timeline .. as I’ve observed plenty of patents come in after one in which I knew personally with less servere circumstances… literally come and go and my child was still suffering in the ER … the Nurse on duty was unaccomidating and almost seemingly unwilling to engage .. as I waited for some kind of answer on when my severely sick child would be seen . I asked if it would be more then another 30 mins and he said he couldn’t promise but shouldn’t be . Well it was . After 45 mins of them calling more then 3 patients who arrived after us .. I reluctantly decided it best to take my fevering , baby who now was covered in feces home.. as she was in her 3rd bowel movement and we had difficulty changing her in the nasty public restroom . I ultimately watched them call two more patients who had come after us exhibiting no signs of eminite health scares then I ordered our ride so I could take my child home to change her and give her medicine to help reduce fever and prevent seizure . I am pissed and very upset that my child and I spent. 3 plus hours we can’t get back in the ER after already being across the street at the Berger building for 3 hours prior this was wayy less then pleasant This is the second poor experience in this particular Emergency Dept but this is the first time it was so horribly handled that I had to leave with not only an even sicker baby then I arrived with . She still now will have to go to another ER to be seen .. because she did infact have a seizure once we got home from her fever that arose& I informed them but that did nothing to medicate the situation or get her seen. Now my kid is home fevering still sick potentially has c-diff and I am skeptical to return her to this terrible hospital because they haven’t even returned my call. I called to speak with charge nurse after filing formal complaint and was told by Jennifer in WR I could not speak to any charge nurse and then she took my information and said a nurse on duty would call back and it’s been an hour with out a returned call. This is negligence and unprofessionalism tht promoted us to leave in the first place and CHOP is looking at a pretty decent lawsuit if we do go to another practice and something is severely wrong with my child with so much documented instances of me trying to get her helper seen and have a team leader consult about next steps. This place wasted my time , cash as it’s costed money I didn’t have to travel to and from and I felt like the poor treatment was racially motivated , as as kid who came in after us was pulled to the back cuz her mother told them she was seizing but I was looking at the child. Who literally just had woke out her sleep. This place is incompetent , and of all the amazing experiences we’ve had here . Today ultimately casted a shadow on them all and I will be contacting the PA board of insurance aswell to file a formal complaint because they need to do better on managing and transparency in the ER wait times. We got there at 12:15 and didn’t receive a text saying my child’s room was ready until 4:15 pm that’s 4 freaking hours for a child who had 2 seizures in past week, has a virus, and cold and caught fever while there … when she has a history of febrile seizures … 0/10 would not recommend. Shame on u all

Very friendly staff and amazing doctors. The information desk is very helpful. The front lobby is well designed and honestly fun to be in due to it's design: there is a meandering ramp that goes up several stories with interesting interactive stops on the way. The lobbies on each floor are also all well laid out: they have great views outside and inside were designed with children and comfort in mind. The plaza out front and the cafeteria/Cafe are both relaxing places to recharge.

My brother was in this hospital because he had appendicitis and had to get surgery and He said the nurse was nice! I think this place is really nice because it's clean and Its nice looking, I know that because I was there to visit him in the hospital. I also want to thank you for saving my Brother before more consequences happened to him and that he could've died.. but thank God this hospital was there! Once again, thank you for saving him🙏🤍 Also I definitely Recommend this place if you want nice doctors and want to feel less anxious and comfortable here.👍

This hospital isn't what it used to be! It seems to be loosing patient focus and fast. We've been a CHLA family for 11 years and I think it's time to switch. My autistic son was SCHEDULED for Dental Surgery. Originally it was supposed to be at 1pm and us be here at 11am. When we got the call from the nurse last night that we needed to be here at 530 AM we were like no one told us! But we got here right on time. We'll let me tell you that they took him upstairs to Surgery PreOp it took over 4 hours to get him into the the surgery room, because he needed to be admitted after surgery and no beds were available. This hospital needs to have better planning for these types of things OBVIOUSLY there will be emergencies that come in over night THAT SHOULD'VE ALREADY BEEN ACCOUNTED FOR!!! Maybe you need more staff and more beds!!! Because to have a child basically starving because you couldn't plan Accordingly is just plainly ridiculous! Then when I spoke to the Charge Nurse in the Surgery Dept she tells me that if my autistic son has an outburst that the anesthesiologist and nurse are there to help give him something to calm down. So basically if my son has an autistic outburst they will just drug him up. I'm like realistically drugging my son just to calm him down because your hospital didn't plan accordingly is uncalled for and unnecessary! Again I am seriously contemplating switching hospitals even though my son is on the Heart Transplant List!!! -A Frustrated Autistic Heart Mom

Ok so I had open heart surgery 20 years ago. I was well cared for and was in icu for three days and then went to a step down room where I was later discharged home after only three days at the hospital. My team was so amazing and so supportive and loving. And a picture of me twenty years later.

My husband and I rushed our son to the hospital last week cos he had a seizure. It was at midnight and they had just one doctor attending to so many people before us so we had to wait for about 7hrs. We were attended to in-between by nurses but the last nurse who came to us started asking some questions that we had already answered over and over again but before she started, she looked at both my husband and I and asked “which one of u can communicate with me better?” We didn’t understand what that meant so my husband asked “what do you mean?” And she said “I need to ask a few questions to whichever one of you can communicate with me better in English” I couldn’t speak out of shock, my husband just walked out of the room cos he didn’t want to get upset, she asked the questions again before I could bring myself to answer her. This was after 6hours of waiting for a doctor. Shortly after, a doctor came in, we were attended to and we left there. The other nurses were sweet but I was disgusted by that nurse thinking we used to live in trees and caves and only spoke gugugaga before coming to Canada.

ACH is so nice that makes me being a kid again, minus sickness. This was my first visit at ACH for my son and we enjoyed the environment.

My son had a very long procedure done in endocrinology, and the nurses there were awesome! They gave my son $15 Apple card for good behavior😄

I found some english speaking doctors here and they have an international office to help you translate if you dont speak spanish. Thank you very much Carolina 🙏

Horrible! Dont go to this clinic. The most unfriendly employees I have experienced in this Hospital. Yes I do speak spanish but once I didnt understand smth the lady just ignored me! Errors start already in front of the Clinic. Apparently they don't know the difference between a Swiss flag and a medical (red!!!) cross. So my question: is this a Swiss Clinic??? Of course not...

My mom got a well planned surgery in this Clinic. Excellent outstanding service what a relief. Fast service, very diligent and well trained all staff. Great place to get well and get some recovery. If you get sick go there you will be fine quickly. Do not visit Los Nogales clinic or La Colina. Marly is the best! Thank you all for your service! Mom is doing great. The doctor was very profesional!

They do not do their job well, 7 hours in the emergency room and do not attend and then say that they cannot attend to a patient

Undoubtedly one of my best experiences, location in the center of the city, excellent medical and administrative staff, old but well-kept infrastructure, spacious with gardens.

This opinion is directed to block 6 of the hospital, which is in an area where you can see people who consume drugs, although there is surveillance and once inside the hospital it is safer, if it is scary, at least walk to the hospital at dawn, and block 6 is opened at 6 in the morning and meanwhile everything is dark or with little light, a perfect place for homeless people, you have to travel with great caution and at least if you are patient and come from somewhere other than Medellín, it is not advisable to be in line before 6 in the morning to check in at block 6, arrive with 5 minutes left or at 6:00 am, there a guard opens the door and when you are already inside the place is much more pleasant and neat, there is a waiting room with chairs where you can wait for them to call you for the billing card, there are elevators, there is natural ventilation in that waiting room, almost all the staff there are friendly to the extent they should be. I give it a 3 star rating, for a not very pleasant event that I had to go through in there, I think that of all the possible days in which that bad event had to happen, it happened just on the day of my appointment, I don't know who it was from the fault of that negligence but thanks to a call to my eps I was able to quickly solve that difficulty so as not to continue in that unpleasant situation in that hospital block.

Excellent...!

3 days waiting in que for gallbladder surgery to be scheduled! Why does the patient get to wait? And why doesn't the clinic approach and explain what's going on to the patient's children.?

Customer service people on their cell phones while helping zero people in the que. The pictures say it all. Look at the customer service people chatting on the phone and the video board showing zero people in the que.

The medical staff at that hospital seem more like a gang of robbers and drug addicts than professionals. Never in my life have I seen such "doctors" and "nurses" so stupid and stupid. They speak ugly, they answer people in a bad way, they morbidize the patients, or rather the little gaminitos are in the wrong place.

The truth is that it seems like a hospital with a very bad service, how is it possible that the patients who are in the ICU do not have the attention they deserve or at least what is necessary. On weekends there are no doctors to give information and the nurses who are there never know anything. In addition to this, during the week they only give one report all day and it is almost at 6 pm. The truth is that they seem very inhuman to me, they should improve this service since it is one of the main clinics in the capital.

Outpatient consultation, terrible service, at 7 AM and only one person serving more than 50 people. By saving a salary they harm us users. Terrible.

All staff member needs an urgent training to learn the meaning of empathy and serve to patients.

The best in town.

Omg I had to walk to the nurses station for everything from a blanket to medication. They have no tv in the rooms. They take for ever. You have to wait 6-8 hours to get something done. Just go to a regular clinic in Barranquilla they are not as nice but they get things done.

An amazing facility with an amazing level of care. Better than any US or German hospital I have ever been in. The office of international patients is very professional and thorough. Dr. Taboada is very thorough and professional. I can't recommend this hospital enough. Super experience.

I came to see if giving birth at Serena del Mar was an option. When I was given a tour of where the mothers and babies stay it was great. I was told to male an appointment to be seen by an obgyn so that they would have a history of me. The nurse took my info days before my appointment but apparently never followed through with setting up my profile. I showed up for my appointment and was never told who I would be seen by. Dr Maria Fernanda Toro Wils was upset that she had to wait on me because the staff had not created my profile. I finally went into my appointment with the doctor and she scolded me and told me she had no time we had to rush. I told her I did not understand whybinwas being treated this way when her staff was a mess. She told me she always does 40 minutes and she dedicated about 20 minutes if that. I left there feeling so upset and totally changed my mind about having my baby there. The treatment from Dr. MARIA Fernanda Toro Wils was terrible. I would not recommend her or her staff in a million years.

They neither answer their phones nor respond to emails seeking an appointment! Terrible customer service. I communicated in Spanish as well so not a language issue.