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If you would like to request a telemed visit, please complete this form. If we are able to treat your condition or questions through telemed , you will receive a confirmatory email or call.

Pick all times that work
Please provide a cell phone number. If you dont have a cell phone or wish to do from your home phone and computer go to next box and type in email. You will receive the link to your cell or email. You will be able to do the visit from your phone or home computer or laptop
Please provide an email to receive the link. Even if using a cell phone please provide an email as a backup.
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