Frontline MDs For Healthcare in front of America's health needs, trust: Frontline Medical Doctors Payments & Check Out HAVING TROUBLE FINDING YOUR RECEIPT NUMBER TO CHECK OUT OR SCHEDULE A FOLLOW UP VISIT? CLICK HERE TO SEARCH FOR Frontline MDs eReceipt # *type your email address and all payments under that address will populate Payments and Check Out Please enable JavaScript in your browser to complete this form.Patient Name *FirstMiddleLastWhat Can We Do For You Today? *1) Schedule An Appointment2) Check Out: WITH $50 Consultation Visit eReceipt #3) Check Out: WITHOUT previous eReceipt #4) FOLLOW UP APPT CHECK OUT5) Monthly Discount Code Checkout (exp JAN 19th))3) For Frontline Members Who Registered During Free Registration and Scheduling Special or Cannot Find Correct Frontline eReceipt # 5) Lookout for specials via emailBest Date & Time For Your Frontline Doctors Appt:DateTimeOPTIONAL: This is used in case of any technical issues, your Frontline Medical Assistant can help get you registered at the best and closest time possible. This is not your confirmed time and date. (UPDATE 01/31/22)Consultation or Complete Appointment: ALL CONSULTATIONS are $50.00 incl. Spouse (Plus One) & Family Consultation *– Select Here –Talk to an MD (TTMD Consultation Only)Spouse Appt (Consultation Only)Family Appt (Consultation Only)Single Complete VisitGOLD Membership Extended Care Treatment PlanComplete Follow-Up Visit (Returning Patients)* A consultation is simply a consultation only. ALL CONSULTATIONS ARE $50.00!! It is an opportunity to talk to your Frontline provider and ensure which treatment plan is best for you. A COMPLETE appointment is a ‘consultation’ AND the corresponding ‘plan of action or treatment plan.’ ASK ABOUT OUR GOLD MEMBERSHIP EXTENDED CARE PLAN. Frontline MDs eReceipt or Transaction ID#: *Input the eReceipt # that correlates with your last Frontline MDs paymentFrontline MDs Check Out Code *Input the CODE # that correlates with your Frontline MDs checkoutIncluding yourself, how many people are checking out for this appointment? *1 person: Single Treatment Plan2 people: Spouse or Plus One Plan3-4 people: Family Treatment Plan(s)Treatment plan you are eligible for or determined best for you by Frontline MDs: *+ Single Consultation Check Out (Paid For Consultation Only)+ Single Extended Care Treatment Plan+ Single Follow-Up Consultation Check Out + Single PDM AppointmentPLEASE READ: If you agree to treatment plan with Frontline MDs AFTER Talk to an MD (Consultation Only), then $50.00 payment counts toward the complete visit or treatment plan cost, it does not cover all cost for a COMPLETE visit which is the ‘consultation plus a plan of action’ from your Frontline provider. Extended Care Treatment Plans include medical follow-ups throughout treatment plan or 3 additional visits at NO EXTRA COST. Treatment plan you are eligible for or determined best for you by Frontline MDs: *+ Spouse Consultation Check Out (Consultation Check Out Plus One Complete Visit)+ Spouse Follow Up Consultation Plus (Follow Up Consultation Check Out Plus Complete Follow Up Visit)+ Spouse Complete Visit Plus (Complete Visit Plus One Additional Complete Visit)+ Spouse Complete Follow Up Plus (Complete Follow Up Plus Check Out For Additional Complete Follow Up Visit)+ Spouse PDM AppointmentPLEASE READ: If you agree to treatment plan with Frontline MDs AFTER Talk to an MD (Consultation Only), then $50.00 payment counts toward the complete visit or treatment plan cost, it does not cover all cost for a COMPLETE visit which is the ‘consultation plus a plan of action’ from your Frontline provider. Extended Care Treatment Plans include medical follow-ups throughout treatment plan or 3 additional visits at NO EXTRA COST. IHTP Appointments must select regular or express.Treatment plan you are eligible for or determined best for you by Frontline MDs: *+ Family Consultation Only Check Out (Consultation Check Out and up to 3 additional Complete visits)+ Family Follow Up Consultation (Follow Up Consultation Plus up to 3 additional Complete Follow Up Visits)+ Family Plus One (Select Family Treatment Plan above AND this Plus One to make it a 5 person family visit)+ Family PDM AppointmentPLEASE READ: If you agree to treatment plan with Frontline MDs AFTER Talk to an MD (Consultation Only), then $50.00 payment counts toward the complete visit or treatment plan cost, it does not cover all cost for a COMPLETE visit which is the ‘consultation plus a plan of action’ from your Frontline provider. Extended Care Treatment Plans include medical follow-ups throughout treatment plan or 3 additional visits at NO EXTRA COST. IHTP Appointments must select regular or express.Did your Frontline provider give you an PDM appointment code? *NoYes*Most will select no. You would receive code explicitly during appointment with provider only.Frontline MDs PDM Appointment Code *This is the code that you explicitly received from your provider and may be up to 20 digits. Covers any additional time and expenses incurred for your provider to monitor and process treatment plans directly. Check-Out W/OUT Receipt # FOR A: *Single Person Complete VisitSpouse Complete VisitFamily Complete VisitCheck out for your Single, Spouse, or Family Visit here.Email for eReceipts *EmailConfirm EmailName On Card *FirstLastName on CardCredit Card: processed and secured by Authorize.Net *Card NumberMM123456789101112Expiration/YY2324252627282930313233Security CodeBilling Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Codeaddress corresponding with card used for paymentPrice: $ 10.00PDM Code Processing Services FeePrice: $ 7.00Check Out Processing Fees $7:Total *$ 0.00For Frontline MDs Consultation and/or Treatment Plan (*Providers Time, Notes and Plan of Action)Signature *Clear SignatureI agree to pay the total above for Frontline Medical Doctors services EmailSubmit Back to Frontline MDs Profile
