For Established Patients Only
This is a secured form for the security of your personal information.
If you are experiencing severe chest pain, shortness of breath, stroke symptoms (such as numbness or weakness on one side of your body or slurred speech), seizures or fits, or any other concerning symptoms that require emergency evaluation, please call 911 on your phone or go to the nearest emergency room.
New Patient Registration, which allows you to request your initial appointment.
For established patients, please complete the form below to request an appointment. You will receive an e-mail when your appointment request is processed. Please allow 4 business hours for a reply.
You can always call our office or LiveChat with the front desk to schedule an appointment as well.
Please provide all of the following information. Incomplete or insufficient information will delay processing of the request.
Additional Fees for Extended Hours Service
In order to help compensate for our higher operating costs during evenings (starting 6 PM) and weekends, Avance Care uses Extended Hours Service specialty code while submitting insurance claim on your behalf for non-preventive care visits. The fee for this service code is up to $50. This fee is added to the baseline charges for your visit. Most insurance companies recognize this billable charge and will provide full or partial reimbursement. You may be responsible for only the allowable portion of this charge in the event that your insurance company assigns it to your deductible or coinsurance.
For self-pay patients, the fee for the Extended Hours Service is $15 for the non-preventive care visit.