MyDrHank Patient Submission

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Referrer URL
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time_zone
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x_disposition
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x_patient_id
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Visit ID
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Status
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Name
First Last
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patient_submission_create_full_name
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Email
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Date
MM slash DD slash YYYY
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Phone
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Dr Selection
- Beluga
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Self Reported Medications
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Medical Conditions
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Allergies
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Drug
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Subscription
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Frequency
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Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Payment
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Beluga Patient Submission Body
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Beluga Patient Submission Status
- start
- pass_submission
- pass_return
- fail
- missing_data
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Alright We're All Set! Now we are sending your information off to our Doctor. Be sure to look for a text message regarding your Medication & Consultation.

Dr Hank is here to help and may reach out if we notice you are not able to complete this process on your own.