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Please complete the entire Request An Appointment form to the right. After we have confirmed payment and reviewed your Appointment Request information we will contact you.
Normal wait time to be contacted is within one hour from submitting the Request An Appointment form.
Copyright © 2021. 24hour Physicians.http://ww.24hourphysicians.com
$("#sss").hide(); $(function(){ $("#medical_concern").change(function(){ $("#current_medical_concern3722").val(''); var displaycode = $("#medical_concern option:selected").val(); if (displaycode == "") { $("#current_medical_concern3722").val(''); $("#sss").show(); } else if(displaycode == "select_medical_concern"){ $("#sss").hide(); $("#current_medical_concern3722").val(''); } else{ $("#sss").hide(); $("#current_medical_concern3722").val(displaycode); }
});
// $("#medical_concern").change(function(){
// var displaycode = $("#medical_concern option:selected").val();
// if (displaycode == "") {
// $("#sss").show();
// }
// else if(displaycode == "Select Medical Concern"){
// $("#sss").hide();
// $("#medical_concern option:selected").val('');
// }
// else{
// $("#sss").hide();
// }
// $("#current_medical_concern3722").val(displaycode);
// });
});
function SubmitPost() { if (!Validate()) { return false; } } $(function () { $('.date').mask('00-00-0000'); }); function isValidDateText(s) { if (s.length > 0) { var bits = s.split('-'); var d = new Date(bits[2] + '/' + bits[0] + '/' + bits[1]); return !!(d && (d.getMonth() + 1) == bits[0] && d.getDate() == Number(bits[1])); } else return true; } function validatePhoneNumber() { if (isNaN($("#tel1-cell_phone1569871587").val()) || isNaN($("#tel2-cell_phone1569871587").val()) || isNaN($("#tel3-cell_phone1569871587").val()) || ($("#tel1-cell_phone1569871587").val() + $("#tel2-cell_phone1569871587").val() + $("#tel3-cell_phone1569871587").val()).length != 10) { alert('Please enter Phone Number correctly'); return false; } return true; } function validatePharmacyNumber() { if (isNaN($("#tel1-preferred_pharm1570200022").val()) || isNaN($("#tel2-preferred_pharm1570200022").val()) || isNaN($("#tel3-preferred_pharm1570200022").val()) || ($("#tel1-preferred_pharm1570200022").val() + $("#tel2-preferred_pharm1570200022").val() + $("#tel3-preferred_pharm1570200022").val()).length != 10) { alert('Please enter Pharmacy Number correctly'); return false; } return true; } function Validate() { if ((!validatePhoneNumber()) || (!validatePharmacyNumber())) { return false; } if (isNaN($("input[name=zip_personal]").val())) { alert("Zip should be a Number"); $("input[name=zip_personal]").focus(); return false; } if (isNaN($("#height_inches_1569871735").val())) { alert("Height should be a Number"); $("#height_inches_1569871735").focus(); return false; } if (isNaN($("#weight_lbs_1569871748").val())) { alert("Weight should be a Number"); $("#weight_lbs_1569871748").focus(); return false; } if (isNaN($("#body_temperature_f_1569871821").val())) { alert("Temperature should be a Number"); $("#body_temperature_f_1569871821").focus(); return false; } if (!isValidDateText($("#date_of_birth1570200138").val())) { alert('Please enter a valid date'); $("#date_of_birth1570200138").focus(); return false; } if (!isValidDateText($("#date_of_last_ph1570200153").val())) { alert('Please enter a valid date'); $("#date_of_last_ph1570200153").focus(); return false; } return true; } function DisplayHideExistingMemberLink() { $("#existingMemberLink").attr("href", ""); var phoneNumber = $("#tel1-cell_phone1569871587").val() + $("#tel2-cell_phone1569871587").val() + $("#tel3-cell_phone1569871587").val(); if (phoneNumber.length == 10) { $.get("https://member.my24hourphysicians.com/user/MemberExists/?phone=" + phoneNumber, function (data, status) { var obj = JSON.parse(data); if (obj == 1) { $("#existingMemberLink").show(); $("#form_list").hide(); $("#existingMemberLink").show(); $("#existingMemberLink").attr("href", "https://member.my24hourphysicians.com/user/loginExternally/?username=" + phoneNumber); window.location.href = "https://member.my24hourphysicians.com/user/loginExternally/?username=" + phoneNumber;
} else {
$("#existingMemberLink").hide(); $("#form_list").show(); $("#Checkcell").hide();
$("#first_name1569871428").focus(); } }); } else { $("#existingMemberLink").hide(); } }
function SubmitPost() { //$("#overlay").fadeIn(300);
$(".form-group").removeClass("has-error"); $(".help-block").remove(); var formData = { cellphone1:$('input[name=tel1-cell_phone1569871587]').val(), cellphone2:$('input[name=tel2-cell_phone1569871587]').val(), cellphone3:$('input[name=tel3-cell_phone1569871587]').val(), preferred_pharm1:$('input[name=tel1-preferred_pharm1570200022]').val(), preferred_pharm2:$('input[name=tel2-preferred_pharm1570200022]').val(), preferred_pharm3:$('input[name=tel3-preferred_pharm1570200022]').val(), first_name: $("input[name=first_name1569871428]").val(), last_name: $("input[name=last_name1569871443]").val(), middle_name: $("input[name=middle_name1569871434]").val(), member_email_address: $("input[name=inputEmail]").val(), member_sex: $("select[name=patients_sex1569871322] option:selected").val(), member_birthday: $("input[name=date_of_birth1570200138]").val(), memberlast_birthday: $("input[name=date_of_last_ph1570200153]").val(), member_address1: $("input[name=street_personal]").val(), member_address2: $("input[name=suit_personal]").val(), member_city: $("input[name=city_personal]").val(), member_state: $("#zone_id").val(), stateofservice: $("#select_a_state_1593193451").val(), member_country: $("select[name=personal_country] option:selected").val(), member_zip: $("input[name=zip_personal]").val(), signature: $("input[name=signature_type_your_full_name1569871904]").val(), member_current_medical_concern: $("textarea[name=current_medical_concern3722]").val(), member_known_allergies: $("textarea[name=known_allergies1569871703]").val(), member_height_inches: $("input[name=height_inches_1569871735]").val(), member_weight_lbs: $("input[name=weight_lbs_1569871748]").val(), member_smoker: $("select[name= smoker1569871769] option:selected").val(), cfid: $("input[name=cfid]").val(), consultationtype: $("input[name=consultationtype]").val(), currentmedicine:$('textarea[name=please_list_all_current_medications_rx_over_the_counter_home_remedy_1569871841]').val(), anymedicalhistory:$('textarea[name=any_medical_history_not_covered_in_any_of_the_previous_questions1569871857]').val(), cardiovascular:$('select[name=do_you_have_cardiovascular_disease1590091650] option:selected').val(), member_body_temperature: $("input[name=body_temperature_f_1569871821]").val(), call_type: $("select[name=call_type] option:selected").val(), primary_physician_name: $("input[name=primary_physician_name]").val(), primaryphysician1: $('input[name=tel1-cell_phone_physician]').val(), primaryphysician2: $('input[name=tel2-cell_phone_physician]').val(), primaryphysician3: $('input[name=tel3-cell_phone_physician]').val(), captcha: grecaptcha.getResponse()
}; var date_of_last = $('input[name= date_of_last_ph1570200153]').val(); var cellphone1 = $('input[name=tel1-cell_phone1569871587]').val(); var cellphone2 = $('input[name=tel2-cell_phone1569871587]').val(); var cellphone3 = $('input[name=tel3-cell_phone1569871587]').val(); var preferred_pharm1 = $('input[name=tel1-preferred_pharm1570200022]').val(); var preferred_pharm2 = $('input[name=tel2-preferred_pharm1570200022]').val(); var preferred_pharm3 = $('input[name=tel3-preferred_pharm1570200022]').val(); var first_name = $('input[name= first_name1569871428]').val(); var last_name = $('input[name= last_name1569871443]').val(); var middle_name = $('input[name= middle_name1569871434]').val(); var member_email_address = $('input[name= inputEmail]').val(); var member_sex = $('select[name= patients_sex1569871322] option:selected').val(); var member_birthday = $('input[name= date_of_birth1570200138]').val(); var member_address1 = $('input[name= street_personal]').val(); var member_address2 = $('input[name= suit_personal]').val(); var member_city = $('input[name= city_personal]').val(); var member_state = $('select[name= personal_state] option:selected').val(); var member_country = $('select[name= personal_country] option:selected').val(); var member_select_a_state = $('select[name= select_a_state_1593193451] option:selected').val(); var member_zip = $('input[name= zip_personal]').val(); var member_current_medical_concern = $('textarea[name=current_medical_concern3722]').val(); var member_known_allergies = $('textarea[name=known_allergies1569871703]').val(); var member_height_inches = $('input[name= height_inches_1569871735]').val(); var member_weight_lbs = $('input[name= weight_lbs_1569871748]').val(); var member_smoker = $('select[name= smoker1569871769] option:selected').val(); var member_body_temperature = $('input[name= body_temperature_f_1569871821]').val(); var cardiovascular = $('select[name= do_you_have_cardiovascular_disease1590091650] option:selected').val(); var member_signature = $('input[name= signature_type_your_full_name1569871904]').val(); var anymedicalhistory= $('textarea[name=any_medical_history_not_covered_in_any_of_the_previous_questions1569871857]').val(); var currentmedicine= $('textarea[name=please_list_all_current_medications_rx_over_the_counter_home_remedy_1569871841]').val(); var call_type = $('select[name= call_type] option:selected').val();
var nameRegex = /^[a-zA-Z ]{2,30}$/; var emailRegex = /^(([^<>()\[\]\\.,;:\s@"]+(\.[^<>()\[\]\\.,;:\s@"]+)*)|(".+"))@((\[[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\])|(([a-zA-Z\-0-9]+\.)+[a-zA-Z]{2,}))$/; if (isNaN(cellphone1) || isNaN(cellphone2) || isNaN(cellphone3) || (cellphone1.toString() + cellphone2.toString()+ cellphone3.toString()).length != 10) { alert('Please enter Phone Number correctly'); return false; } if (!nameRegex.test(first_name)) { alert('Please enter a valid First Name'); $("#first_name1569871428").focus(); return false; }
if (!nameRegex.test(last_name)) { alert('Please enter a valid Last Name'); $("#last_name1569871443").focus(); return false; } if (!emailRegex.test(member_email_address)) { alert('Please enter a valid Email Address'); $("#inputEmail").focus(); return false; } if (member_sex==="") { alert('Please enter a valid Sex'); $("#patients_sex1569871322").focus(); return false; } if (member_birthday==="") { alert("Please enter member birthday."); $('input[name= date_of_birth1570200138]').focus(); return false; } if (member_address1==="") { alert('Please enter a valid Address1'); $("input[name=street_personal]").focus(); return false; } if (member_city==="") { alert('Please enter a valid City'); $("input[name=city_personal]").focus(); return false; } if (member_state=="") { alert('Please enter a valid State'); $("#zone_id").focus(); return false; } if (member_country=="") { alert('Please select a valid Country'); $("#country_id").focus(); return false; } if (member_zip==="" || isNaN(member_zip)) { alert("Please enter zip."); $('input[name= zip_personal]').focus(); return false; } if (member_select_a_state=="") { alert('Please select State of Service'); $("#member_select_a_state").focus(); return false; } if (call_type==="") { alert('Please select call type'); $("#call_type").focus(); return false; } if (isNaN(preferred_pharm1) || isNaN(preferred_pharm2) || isNaN(preferred_pharm3) || (preferred_pharm1.toString() + preferred_pharm2.toString()+ preferred_pharm3.toString()).length != 10) { alert('Please enter Pharmacy Fax No'); return false; } if (member_current_medical_concern.trim()=="") {
alert("Please enter member current medical concern."); if($("#medical_concern").val()=='') { $('#current_medical_concern3722').focus(); } else{ $("#medical_concern").focus(); }
return false; } // if (member_current_medical_concern==="") { // alert("Please enter member current medical concern."); // $('input[name= current_medical_concern3722]').focus(); // return false; // } if (member_known_allergies==="") { alert("Please enter Allergies."); $('textarea[name= known_allergies1569871703]').focus(); return false; } if (member_height_inches==="" || isNaN(member_height_inches)) { alert("Please enter height."); $('input[name= height_inches_1569871735]').focus(); return false; } if (member_weight_lbs==="" || isNaN(member_weight_lbs)) { alert("Please enter weight."); $('input[name= weight_lbs_1569871748]').focus(); return false; } if (member_smoker==="") { alert("Please select Smoker."); $("smoker1569871769").focus(); return false; } if (member_body_temperature==="" || isNaN(member_body_temperature)) { alert("Please enter temp."); $('input[name= body_temperature_f_1569871821]').focus(); return false; } if (currentmedicine==="") { alert("Please enter current medicine."); $('textarea[name= please_list_all_current_medications_rx_over_the_counter_home_remedy_1569871841]').focus(); return false; } if (date_of_last==="") { alert("Date of last Physical is required."); $('input[name= date_of_last_ph1570200153]').focus(); return false; } if (anymedicalhistory==="") { alert("Please enter any medical history."); $('textarea[name= any_medical_history_not_covered_in_any_of_the_previous_questions1569871857]').focus(); return false; }
if (cardiovascular==="") { alert('Please enter a valid cardiovascular'); $("#do_you_have_cardiovascular_disease1590091650").focus(); return false; } if (member_signature==="") { alert('Please enter a Signature'); $("#signature_type_your_full_name1569871904").focus(); return false; }
$.ajax({ type: "POST", url: "https://my24hourphysicians.com/Members/addMember", data: formData, dataType: "json", encode: true, }) .done(function(data) {
if (data.success) {
location.href=data.url;
} else { grecaptcha.reset(); alert(data.error);
//alert(data.errors);
} })
.fail(function(data) { console.log(data);
});
return false;
}