New provider attestation visit
Send link to patient
Schedule for patient
Patient first name
Patient last name
Date of birth
Visit language
English
Español
SCN Lead Entity
Patient email
Contact number
Phone number
The clinician will call this number at the appointment time.
Patient's address
Street address
City
State
ZIP code
Insurance
Insurance carrier
Insurance member ID
Insurance card photos
optional
Front of card
Tap to take a photo or upload
Back of card
Tap to take a photo or upload
Eligibility screening
Check any that apply. These pre-check matching boxes for the clinician.
Schedule the visit
Visit date
Visit time
Create & send to patient →
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Visit created
Share this personal link with the patient to complete their information and pick a visit time.
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