Get in touch!

Use this form if you have any additional questions about our practice.

Please go to our scheduling page to book an appointment.
You will find answers to common questions about insurance and how Vida Telehealth works on our FAQ page.
For medication refills, other health questions, medical related concerns please use the secure patient portal.

Name

First Name

Last Name

Phone

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How do you prefer to be contacted?

Is there anything you'd like to share with me prior to our conversation?

Note: Please do not include Personal Health Information in this form.