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Table Rock Mobile Medicine Scheduling Form
Fill out the required information to schedule an appointment online.
Patient's Date of Birth
Preferred method of confirming appointment
Preferred appointment date/time
Type of Payment?
We are currently not in network for certain Medicare Advantage plans including True Blue. We can still bill your insurance but it would be considered out of network. We are working on this every day. Follow us on Facebook to get updates on when these are approved.
Blue Shield (Regence)
Cash/Credit/Debit (if paid in full at time of visit, a 50% discount will be applied to the total bill)
Reason for visit
Sore throat, UTI, Cough, Sports Physical, Allergies, Ear pain, etc
If this is a same day visit request, please submit this form and also call/text Table Rock Mobile Medicine's phone to notify the provider of the request. This helps to ensure immediate requests are expedited.
This is a same day request. (Please contact the provider at 208-991-3232 to alert them)
This is a schedule request for a future date. (The provider will contact you to confirm)
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