Check in for your clearance

A short video visit with a nurse practitioner before your treatment. All fields are required.

First name

Last name

Mobile phone number

So we can match your appointment. Any format is fine.

Date of birth

For example, 3 27 1985

Month

Day

Year

Allergies

Medicines, foods, latex or anything else.

I have no known allergies

I consent to a video exam with a Hydration Room nurse practitioner.

This device is the clinic iPad

Staff turn this on once on the clinic iPad. Adds "I'm done" in the waiting room and clears an unfinished check-in after 90 seconds of inactivity.