Get On The Waitlist Has the patient been diagnosed with EDS? —Please choose an option—YesNoUnknown Has the patient been diagnosed with CCI? —Please choose an option—YesNoUnknown Is the patient interested in telehealth or in-person appointments? —Please choose an option—TelehealthIn-Person If you have BCBS, is it an Anthem or Blue Choice plan? —Please choose an option—AnthemBlue ChoiceNeither Attach a copy of the front and back of your driver's license and insurance card, and a referral, if you have one.
