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Forgetting something? Hint: Email Address.
Please enter correct email address.
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Forgetting something? Hint: Password.
Oops! Try again; this time make it 6 to 12 characters.
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Not readable? Change text.
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Patient Name
Forgetting something? Hint: Your Name.
Is that really your name? Please try again.
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Date of Birth
Forgetting something? Hint: Date of birth.
Please enter a valid date
Gender
Forgetting something? Hint: Gender.
SSN
(Last 4 Digits)
Forgetting something? Hint: SSN Number.
Please enter at least last four digits of your SSN.
Forgetting something? Hint: SSN Number.
Please enter at least last four digits of your SSN.
Oops! Try again; your SSN don't match.
Address
Forgetting something? Hint: Address 1.
Forgetting something? Hint: City.
State
{{value}}
Forgetting something? Hint: State.
Forgetting something? Hint: Zip Code.
Oops! Try again.
Email Id
Forgetting something? Hint: Email Address.
Please enter correct email address.
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Forgetting something? Hint: Re-type Email Address.
Oops! Try again;
Oops! Try again; your email address don't match.
Password
Forgetting something? Hint: Password.
Oops! Try again; this time make it 6 to 12 characters.
Forgetting something? Hint: Re-type Password.
Oops! Try again; this time make it 6 to 12 characters.
Oops! Try again; your password don't match.
Phone Number
Forgetting something? Hint: Phone number
Oops! Try again; this time no funny characters.
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We will send you a one-time activation code to the number entered above to complete your enrollment. How do you want the code delivered?
Text message
Voice call
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Enter the guardian information
(Only for underage patients)
Full Name
Forgetting something? Hint: Guardian's Name.
Is that really your name? Please try again.
Date of Birth
Forgetting something: Guardian's DOB.
Oops.. Too Young!
Gender
Forgetting something? Hint: Guardian's gender
Patient is my
Select Relation
{{rel.id}}
Forgetting something? Hint: Relationship to patient.
Address
Forgetting something? Hint: Address 1.
Same as Patient
Forgetting something? Hint: City.
State
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Forgetting something? Hint: State.
Forgetting something? Hint: Zip Code.
Oops! Try again.
I have read and accept openDoctor
Terms of Service
Forgetting something? Hint: Accept the terms.
Submit
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User Authentication
Enter the activation code sent via SMS/text to your phone number
Forgetting something? Hint: Your Authentication.
Invalid code.
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Send a new authentication code
Submit
Forgetting something? Hint: Cell phone.
We will send you a one-time activation code to the number entered above to complete your enrollment. How do you want the code delivered?
Text message
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TYPE OF APPOINTMENT
APPOINTMENT QUESTIONS
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Type of Appointment
Step 1
Select appointment type below.
Request for Appointment?
ADD Patient
Selection is required.
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> {{rfcText[technologyData.row]}}
{{Modality[technologyData.row]}}
{{tech.technology}}
{{tech.technology}}
{{BodyPart[technologyData.row]}}
{{bodyPartData.display}}
{{bodyPartData.display}}
{{SubBodyPart[technologyData.row]}}
{{subBodyPartData.display}}
{{subBodyPartData.display}}
{{Position[technologyData.row]}}
{{positionData.display}}
{{Position[technologyData.row]}}
{{positionData.display}}
Reason for consultation
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Selection is required.
Need more tests?
Selection is required.
OR
Select Specialty
{{sp.specialty_name}}
Please select Specialty.
Select Reason For Consultation
{{selectionTextFinal[technologyData.row]}}
> {{rfcText[technologyData.row]}}
{{Modality[technologyData.row]}}
{{tech.technology}}
{{tech.technology}}
{{BodyPart[technologyData.row]}}
{{bodyPartData.display}}
{{bodyPartData.display}}
{{SubBodyPart[technologyData.row]}}
{{subBodyPartData.display}}
{{subBodyPartData.display}}
{{Position[technologyData.row]}}
{{positionData.display}}
{{Position[technologyData.row]}}
{{positionData.display}}
Reason for consultation
{{rfcData.display}}
Selection is required.
I'll select insurance later
Select insurance {{insuranceType}}
{{selectionTextRfc}}
{{rfcRow.name}}
Reason for Consultation
{{rfcRow.name}}
Selection is required.
{{selectionTextInsurance}}
Insurance
{{insuranceRow.name}}
Insurance Address
{{addressRow.name}}
{{selectionTextInsuranceAddress}}
Please select insurance company and insurance address.