Individuals in their day-to-day are demanded to make choices in contexts of services with mild and severe consequences. Decisions with severe consequences are difficult situations where choices are dilemmas that cause stress and severe emotional reactions (botti et al, 2009; Kahn, luce, 2003). The mild decisions, in turn, involve situations that represent a low risk and uncertainty to decision maker. However, despite the differences seen in the literature, the consequences of decisions - mild and severe - have rarely been seen in consumer behavior studies. This theoretical essay aims to investigate the moderator effect of the consequences of the exchange of relations between trust and its antecedents and consequences in the context of provision of medical services. Consumer confidence plays a key role, especially in situations of severe changes, as it reduces the perception of risk, since it helps the individual to form consistent expectations regarding the service provider. Comparing exchanges with mild versus severe consequences, affection will have a greater impact on confidence in exchanges with severe consequences comparing with mild exchanges. In turn, the cognition effect will be moderated by the type of exchange, because it is believed that in both exchanges, with mild and severe consequences, cognition will play an important role in reducing uncertainty and increasing confidence. Regarding the consequences of confidence, it is believed that the more severe are the consequences of the exchanges, the strongest will be the relationship between trust and the treatment continuity intent, word-of-mouth and search for a second opinion.