Ask the Doctor

If you don't have the time to make it into the office to see Dr. Green why not have an electronic visit instead? Please complete the following form and submit it to Dr. Green.

1. name

2. contact information: a phone number that accepts calls from blocked numbers, FaceTime or webcam and/or email address

3. date of birth (month/day/year)

4. age (in years)

5. allergies to medications

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Online consultations are $50.00. Payments can be made after all information is submitted to Dr. Green.

7. please list any and all medications that you are currently taking

8. please list all past surgical procedures

6. please detail your past medical history below

9. please detail your current medical problem i.e. when your symptoms began, what have you taken for your symptoms, what makes you feel better or worse, etc.

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Please carefully review the information before your final submission.

Dr. Green will contact you with a diagnosis and a treatment plan. If an office visit is required a claim will be filed with your insurance company. Your payment will be applied to that bill. If you have no insurance your payment will be applied as a credit for an office visit.