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Request Appointment @ Dallas TX- Womens Wellness & GYN
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Time Slots*
8:30 AM - 8:40 AM
8:40 AM - 8:50 AM
8:50 AM - 9:00 AM
9:00 AM - 9:10 AM
9:10 AM - 9:20 AM
9:20 AM - 9:30 AM
9:30 AM - 9:40 AM
9:40 AM - 9:50 AM
9:50 AM - 10:00 AM
10:00 AM - 10:10 AM
10:10 AM - 10:20 AM
10:20 AM - 10:30 AM
10:30 AM - 10:40 AM
10:40 AM - 10:50 AM
10:50 AM - 11:00 AM
11:00 AM - 11:10 AM
11:10 AM - 11:20 AM
11:20 AM - 11:30 AM
11:30 AM - 11:40 AM
11:40 AM - 11:50 AM
11:50 AM - 12:00 PM
12:00 PM - 12:10 PM
12:10 PM - 12:20 PM
12:20 PM - 12:30 PM
12:30 PM - 12:40 PM
12:40 PM - 12:50 PM
12:50 PM - 1:00 PM
1:00 PM - 1:10 PM
1:10 PM - 1:20 PM
1:20 PM - 1:30 PM
1:30 PM - 1:40 PM
1:40 PM - 1:50 PM
1:50 PM - 2:00 PM
2:00 PM - 2:10 PM
2:10 PM - 2:20 PM
2:20 PM - 2:30 PM
2:30 PM - 2:40 PM
2:40 PM - 2:50 PM
2:50 PM - 3:00 PM
3:00 PM - 3:10 PM
3:10 PM - 3:20 PM
3:20 PM - 3:30 PM
3:30 PM - 3:40 PM
3:40 PM - 3:50 PM
3:50 PM - 4:00 PM
4:00 PM - 4:10 PM
4:10 PM - 4:20 PM
4:20 PM - 4:30 PM
4:30 PM - 4:40 PM
4:40 PM - 4:50 PM
4:50 PM - 5:00 PM
I'm a new patient at this practice
First Name*
Last Name*
Email*
Phone Number*
Date of Birth [mm/dd/yyyy]*
Select insurance
No Insurance
Aetna
AllWell
Ambetter
Amerigroup
Baylor Scott & White Health Plans
BCBS
Childrens Medicaid & CHIP
Cigna
HealthSpring
Humana
Imagine Health
Medicare
Molina
Texan Plus
United Health Care
WellMed
Other Insurance
Insurance Member ID#*
Insurance Group ID#
Additional notes for the practice
How did you hear about us?
Insurance provider
Online search e.g. Google, Bing
Online review site e.g. Yelp, Healthgrades
Referral from healthcare provider
Referral from friend/colleague
Local advertisement
Other
I have read and agreed to the
Privacy Policy
and
Terms of Use
that I am at least 13 and have the authority to make this appointment
I agree to receive text messages from this practice and understand that message frequency and data rates may apply
Request Appointment
Please note this is an appointment request and the practice will call you to confirm your appointment time.