Basic Questions HOW CAN WE HELP?
Sorry, your telemedicine request has been declined. Please schedule an appointment for a physician consultation.
1
Please provide your personal info.

Your data is secured with 256-bit TLS. Only your physician and the iLiveActive Care Team will have access to your profile.


PLEASE ENTER YOUR DETAILS (NAME MUST MATCH YOUR ID)
First Name
Last Name
Email
Address Line1
Address Line2
Country
State
City
ZipCode
Share a photo of yourself.
Telemedicine laws require a physician to know who they are treating. This is why we ask for a photo of driving license. This images is securely stored and only seen by your physician and the iliveactive Care Team.

PICTURE OF YOUR PHOTO.

Your face is well-lit and not blurry

Please take a photo of your driver's license.
Telemedicine laws require a physician to know who they are treating. This is why we ask for a picture of your Driver's License. This image will be securely stored and only seen by your physician and the iLiveActive Care Team.

PICTURE OF YOUR DRIVING LICENSE.

Your full name and DOB must be legible.

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