Steps to Renew

1. Complete Intake

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Fill out health intake via phone/email to on our secure HIPAA compliant systems. Existing patients fill out the renewing intake forms provided. 

2. Process Renewal

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3. Physician Review

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After doctor evaluates your health intake. Doctor can setup a phone call with you for your phone consult. You then will receive a digitally signed letter, a hard copy and email receipt. 

Select your letter below

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Renewal Intake Provided Here

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Secure Health Intake Form

Click thru the link to access the HIPAA secure intakeQ form. Simply enter your name and number to enter, fill out best you can, open/sign consent, and submit. That's it! Any questions give us an email, text, or call.  info@uconnectmedical.com 800-840-4249

Intake Form

Want to fill out the health intake form first?

Not a problem, we have supplied the form link here. Since you are a returning/renewing patient our process can be either pay as you go and fill out form, or vice versa. We keep it simple. Click link below. 

Renewal Intake Form

Still have questions?

Give us a call  800-840-4249 or fill out the contact form for support

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