What is your preferred langauge?

    • [[{"field_id":16006,"subrules":{"field_id":16004,"value":"English","operator":"Match"}}],[{"field_id":16074,"subrules":{"field_id":16004,"value":"Spanish","operator":"Match"}}],[{"field_id":16012,"subrules":{"field_id":16004,"value":"Others","operator":"Match"}}]]

Would you like us to provide an interpreter for your appointment for a fee of $24.99?

    • [[{"field_id":16006,"subrules":{"field_id":16012,"value":"Yes, I agree to pay $24.99 for an interpreter","operator":"Match"}}],[{"field_id":16006,"subrules":{"field_id":16012,"value":"No, I do not need an interpreter","operator":"Match"}}],[{"field_id":16006,"subrules":{"field_id":16012,"value":"I will have an adult family member or friend interpret for me","operator":"Match"}}]]

¿Desea que le proporcionemos un intérprete para su cita?

    • [[{"field_id":16075,"subrules":{"field_id":16074,"value":"No, no necesito un int\u00e9rprete","operator":"Match"}}],[{"field_id":16075,"subrules":{"field_id":16074,"value":"\u00a0Traer\u00e9 mi propio int\u00e9rprete (debe tener al menos 18 a\u00f1os o m\u00e1s)\n","operator":"Match"}}],[{"field_id":16075,"subrules":{"field_id":16074,"value":"Por favor, proporci\u00f3nenme un int\u00e9rprete para mi cita. Acepto pagar 24,99 $ por el servicio de int\u00e9rprete","operator":"Match"}}]]

Do you have any of the following symptoms that may require in person emergency care?
 

    • [[{"field_id":16013,"subrules":{"field_id":16006,"value":"None of the above","operator":"Match"}}]]

¿Tiene alguno de los siguientes síntomas que puedan requerir atención de emergencia en persona?

    • [[{"field_id":16076,"subrules":{"field_id":16075,"value":"Ninguno de los anteriores\n","operator":"Match"}}]]

Are you experiencing a psychiatric emergency? (For example: suicidal thoughts, thoughts to harm yourself or others, or uncontrolled hallucinations)

    • [[{"field_id":16007,"subrules":{"field_id":16013,"value":"No","operator":"Match"}}]]

¿Está experimentando una emergencia psiquiátrica? (Por ejemplo: pensamientos suicidas, pensamientos de hacerse daño a sí mismo o a otros, o alucinaciones incontroladas)

    • [[{"field_id":16077,"subrules":{"field_id":16076,"value":"No","operator":"Match"}}]]

Which state are you currently located in?

    • [[{"field_id":16008,"subrules":{"field_id":16007,"value":"Oregon - OR","operator":"Match"}}],[{"field_id":16008,"subrules":{"field_id":16007,"value":"Washington - WA","operator":"Match"}}],[{"field_id":16008,"subrules":{"field_id":16007,"value":"Texas -\u00a0TX","operator":"Match"}}]]

¿En qué estado se encuentra actualmente?

    • [[{"field_id":16078,"subrules":{"field_id":16077,"value":"Oregon - OR","operator":"Match"}}],[{"field_id":16078,"subrules":{"field_id":16077,"value":"Washington - WA","operator":"Match"}}],[{"field_id":16078,"subrules":{"field_id":16077,"value":"Texas -\u00a0TX","operator":"Match"}}]]

Would you like to pay for your telehealth appointment? 

    • [[{"field_id":16009,"subrules":{"field_id":16008,"value":"General Public Amount - $74.99","operator":"Match"}}],[{"field_id":16009,"subrules":{"field_id":16008,"value":"Service Members, Students, First Responders - $49.99","operator":"Match"}}],[{"field_id":16009,"subrules":{"field_id":16008,"value":"I will pay $20 today; and agree to enroll in a monthly payment plan for the remaining amount charged to the card on file.","operator":"Match"}}]]

¿Te gustaría pagar por tu cita de telemedicina?

    • [[{"field_id":16080,"subrules":{"field_id":16078,"value":"Cantidad del p\u00fablico en general - $74.99","operator":"Match"}}],[{"field_id":16080,"subrules":{"field_id":16078,"value":"Miembros del servicio, estudiantes, primeros respondedores - $49.99","operator":"Match"}}],[{"field_id":16080,"subrules":{"field_id":16078,"value":"Pagar\u00e9 $20 hoy; y acepto inscribirme en un plan de pago mensual por el monto restante que se cargar\u00e1 a la tarjeta registrada.","operator":"Match"}}]]

Are you a new patient/ follow up

    • [[{"field_id":16010,"subrules":{"field_id":16009,"value":"New Patient","operator":"Match"}}],[{"field_id":16011,"subrules":{"field_id":16009,"value":"Follow Up Patient","operator":"Match"}}]]

¿Es usted un paciente nuevo/seguimiento?

    • [[{"field_id":16081,"subrules":{"field_id":16080,"value":"Nuevo Paciente\n","operator":"Match"}}],[{"field_id":16082,"subrules":{"field_id":16080,"value":"Paciente de seguimiento\n","operator":"Match"}}]]

Do you want to establish PCP with our practice?

¿Quiere establecer PCP con nuestra práctica?

Do you have a virtual PCP with us?

¿Tienes un PCP virtual con nosotras?