OHIO Patients

OHIO PATIENTS

Welcome to Jiffy Doctor Ohio! We are grateful to you as our valued patient. Let's get you registered!
Name*

First NameLast Name
We are excited you are here. Jiffy Doctor Clinics makes the process easy and quick! $49.99 for your telehealth doctor's visit! We look forward to serving you.
Email
example@example.com
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.
Date

YearMonthDay
Date

My Products

Full Service New Patient or Renewal PatientFull Service doctor's appointment.

$49.99

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please upload your medical records here.

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Please upload your Driver's License here:

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Jiffy Doctor - Patient Registration

Please Note:The time you select is for our provider to review your information—it is not the exact time you will receive a phone call. You will be contacted on the same day as your appointment.Our cutoff time is 6:00 p.m.. CST. If you register after 6:00 p.m. CST, you will receive a call the following day.For smoother communication, please add 405-655-8028 to your contacts.
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OHIO PATIENTS