Elko TeleMedicine

Please Be Advised

Medallus Medical (Elko) monitors the telemedicine program during the operational hours listed. If you are experiencing an emergency or need to be evaluated after our business hours please go to your nearest ED or call 911.
How May We Help You?

This link is secure. Please complete the form below to be connected to our telemedicine portal. You will only be charged after you discuss your concerns with our Medical Care team so that you can talk with our provider confidentially over video-chat.
Please indicate the reason for your visit today: *

Urgent Care Scheduled Primary Care
Please explain your Urgent Care needs:
Upload State ID or Driver's License *
Upload State ID or Driver's License
Patient's Full Name *
Phone Number *

Area Code Phone Number
Date of Birth *

Month Day Year
Date
E-mail Address *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Have you previously been a patient of Medallus? *

Yes No

Do you have health insurance? *

Yes No
Who is your health insurance carrier?
Upload FRONT of Insurance Card
Upload BACK of Insurance Card
Do you have a Medallus Membership? *

Yes No
How did you hear about our TeleMedicine service? *
After submitting your intake form, you will be logged onto our TeleMedicine Portal. Our Medical Assistant will be contacting you shortly to connect you with one of our providers.

Please have your ID, CoPay or Visit Fee (if applicable) and/or Insurance Card (if applicable) ready.
I give my consent for the use of telemedicine in my medical care rendered to me (or to my legal minor) by the medical staff at Medallus Medical (ELKO). If this is an emergency please call 911 or go to the nearest emergency room. Please note that our medical provider may determine that you will need to come into your local Medallus Medical clinic. In such cases, your visit fee or co-pay will be applied towards the clinic visit.
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How May We Help You?