Are you a new patient or established patient?

  • [[{"field_id":15085,"subrules":{"field_id":15084,"value":"New Patient","operator":"Match"}}],[{"field_id":15086,"subrules":{"field_id":15084,"value":"Established","operator":"Match"}}]]

Is the patient under the age of 18?

Have you been seen in the office in last 2 years or less?

  • [[{"field_id":15087,"subrules":{"field_id":15086,"value":"Yes","operator":"Match"}}]]

What kind of appointment would you like to schedule?