COVID-19 Screening & Telemedicine VisitsPlease enable JavaScript in your browser to complete this form.Location *ArlingtonBurlesonCoppellFarmers BranchPlanoSelect a Service *TelemedicineCovid-19Covid-19 & TelemedicineName *FirstLastDate / Time *Home Address *Email *Phone *Preferred Pharmacy/Address or Crossroads *Primary Insurance Plan *Primary Insurance: Policy Holder Name *Primary Insurance: Date of Birth *NameSubmit
