Are you a new or returning patient?

  • [[{"field_id":10413,"subrules":{"field_id":10412,"value":"New Patient","operator":"Match"}}],[{"field_id":10415,"subrules":{"field_id":10412,"value":"Returning Patient","operator":"Match"}}]]

Would you like to be seen in office or virtually?

  • [[{"field_id":10416,"subrules":{"field_id":10413,"value":"Virtually","operator":"Match"}}]]

Would you like to be seen in office or virtually?

  • [[{"field_id":10414,"subrules":{"field_id":10415,"value":"Virtually","operator":"Match"}}]]

Are you located in the state of Florida?

Are you located in the state of Florida?