TELEMEDICINE

Please complete the form below. Make a payment for

  1. Medical Consultation for up to 15 mins (16 years or older) – $60
  2. Detailed Medical Consultation up to 30 mins – $120
  3. Weight Loss consultation – $85
  4. Suboxone opioid Treatment $100

Note: Currently, we are accepting patients in PA state only for Telemedicine. We will be adding the other states soon.

Once our staff receives your completed form and the payment, you will receive a text for the time of your appointment.

give details of medical consultation required
select one
D.O.B. format mm/dd/year
SS # format xxx-xx-xxxx
if none, write none
format 555-555-5555
if any, format 555-555-5555
if none, write none
-
for patient
Give location address of Pharmacy
write your name
if patient is 18 years or older, write N/A
Select one

Thank you.

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