Is this a request for a new or a returning patient? 

    • [[{"field_id":17939,"subrules":{"field_id":17938,"value":"New Patient","operator":"Match"}}],[{"field_id":17939,"subrules":{"field_id":17938,"value":"Returning Patient","operator":"Match"}}]]

Is your visit type Telehealth or In-Office?

    • [[{"field_id":17940,"subrules":{"field_id":17939,"value":"Telehealth","operator":"Match"}}],[{"field_id":17940,"subrules":{"field_id":17939,"value":"In-Office","operator":"Match"}}]]

What is the reason for your visit?