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Schedule an appointment header
Schedule an appointment

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We reserve appointments for 15 minutes. If you do not confirm in this timeframe you will need to close your browser and begin a new search.

Appointment Details label
Appointment Details

Scheduling with label
Scheduling with

Condition or visit reason label
Condition or visit reason

Mnemonic Disclaimer
If you change your condition type, you will need to reselect your location and time slot.
Condition or visit reason disclaimer
This reason for visit requires a referral from a doctor.

Visit type label
Visit type

Visit type disclaimer
If you select a different visit type, you may be required to choose a new date & time.

Location Label

Telehealth Visit Box Title
Telehealth Visit
Telehealth visit text box
Telehealth allows you to be seen via a computer or mobile device. You will be sent a link upon scheduling your appointment.
Location disclaimer
If you select a different location, you may be required to choose a new date & time.

Day & time label
Day & time

Patient Information Label
Patient Information

Patient Information Label
Patient Information

Full name Label
Full name
Required Tag
Add a preferred name text
Add a preferred name
Date of birth label
Date of birth (MM/DD/YYYY)
Required Tag
Sex label
Sex (as listed with health insurance)
Required Tag
Add gender information label
Add gender information

Address and contact information label
Address & Contact Information

Preferred contact method label
Preferred contact method
Optional Tag

Patient Visit Information Label
Patient Visit Information

Reason for visit label
Reason for visit:

Insurance information label
Insurance Information

Upload insurance card label
Upload insurance card images
Optional Tag
Required Tag
Front of insurance card text
Front of insurance card
Back of insurance card
Back of insurance card
Insurance disclaimer
If you choose not to upload or add insurance information, please bring a copy of your insurance card with you to the appointment.

Referral Information Label
Referral Information

Insurance does not require referral text
Does your insurance require a referral to see a specialist?
Required Tag
Upload referral image label
Upload referral image
Optional Tag
Required Tag
Referral Image Upload Text
Referral Image
Referral disclaimer
Please bring a copy of your referral with you to the appointment