Waitlist Application

Thank you for your interest in working with Good Doctors.

Because we intentionally maintain a limited patient roster, openings become available periodically. Please complete the form below to be added to our waitlist, receive more information about our program, and be notified when an opening becomes available.

There is no obligation to join our practice by submitting this application.

First Name

Last Name

Phone *

Email *

Date of birth

City

State

Who referred you to us? (enter 'n/a' if no one)

What are your primary health goals or concerns? *

By checking this box, I consent to receive non-marketing text messages from Good Doctors about the program and availability. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive messages and updates among others, from Good Doctors at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.