If you wish to be seen in consultation via our web video-conferencing site, please download, print, and complete the patient registration form below.
Make sure you sign the areas on the form where indicated.
Mail the form to our address below: M. Rezaian, MD 176 Healthcare Lane, Suite 1 Martinsburg, WV 25401
Once we recieve the form, we will contact you to set up your online appointment.
Please note that online Web-conferencing is not for urgent medical consults or emergencies. If you have an urgent problem or an emergency please call 911 immediately.
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