Andrew Barbash, MD - Publicforms

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NeuroDox-Request a Mobile Video Link

Meet with a Neurologist by Secure Mobile Video Chat

We will be meeting by secure HIPAA-compliant video chat from ANY device...NO app to install and no IT support needed

Your Name *

First AND Last Name Please

Your Mobile Number (Smartphone) *

We MUST be able to communicate by SMS text to a smartphone for reliable contact.

You can connect by mobile phone, computer or tablet

How would you prefer to receive the meeting link *

Mobile phone

Email address

No preference

You decide whether you wish to do the video session on your phone or computer/tablet

Email (Optional)

IF you will want to meet on your computer or tablet instead of a smartphone, then we can send the link to your email. If that is preferred, then enter your email. Otherwise leave this blank

If you need to add any text comments

Comments (Optional)

If you want to provide any relevant information that would be helpful to the visit, this is all secure and arrives in my clinical inbox

How to expect a reply or link to the waiting room

I will send back a unique meeting link. This will enter you in a waiting room, I am notified, and then will start the video session. If this is not scheduled and you do not receive a text reply within a few minutes, I am not available at this time

* Required field