Appointment Scheduling Tool
Welcome! To get started, enter the member’s Date of Birth and the Member/Subscriber ID issued by the health plan.
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of Birth Text
Member/Subscriber ID
*
DOB
Member Initials
*
Please confirm that the Member Initials shown above are correct.
*
Yes, the initials are correct
No, the initials are not correct
Please verify the Member/Subscriber ID and Date of Birth entered above and try again.
Select an Appointment Date and Time
*
Please choose your preferred communication method to receive your appointment confirmation.
*
Please Select
Text Message
E-Mail
Phone
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Comments
NOTE: Please advise the member of the three-hour visit window.
Schedule
Should be Empty: