Online doctor appointments are as easy as 1-2-3.
Affordable care starts here!
Reason for visit
Enter a brief comment or note, e.g., UTI
Patient Name
*
First Name
Last Name
DOB
*
MM/DD/YYYY
Sex
*
Female
Male
Address
Enter home address here
Enter Pharmacy Name & Address (optional)
Email address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Insurance information (optional)
Insurance Name
Insurance ID Number
preferred Appointment Date
Select one option below
*
prev
next
( X )
Insurance option or New Patient discount
Online doctor appointment
$
20.00
Â
Â
Self-pay-No insurance
Online doctor appointment.
$
55.00
Â
Â
Credit Card
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