AFC Urgent Care Lakewood Colorado

Virtual Visit

Closed

MDT

REASON FOR VIDEO VISIT

CHOOSE A DATE AND TIME:

HAVE YOU BEEN TO AFC URGENT CARE LAKEWOOD COLORADO BEFORE?:

Yes

PATIENT INFO:

Patient first name

Patient last name

Year

Mobile number

Email address

HOME ADDRESS:

Street Address

Apt, Suite, etc (optional)

City

ZIP code

HOW DO YOU WANT TO PAY?

Insurance

Self-Pay

If you select insurance, your responsibility will vary depending on your plan. Self-pay is a flat rate of $100.

I have read, understand and agree to Solv Health’s Terms of Service, Financial Relationships, and Privacy Policy.

I give my consent for the use of telemedicine in my medical care and have read, understand, and agree to these Terms

Bookings by Solv.

For emergencies please call 911