September 6, 2018 islavin Request An Appointment COVID-19 update For the duration of the COVID-19 emergency, Dr. Bard is continuing to see patients via a telehealth solution. All you need is an Internet-connected device (computer, tablet, or a phone) with a camera and microphone. Under federal guidelines, insurance companies relaxed their rules related to telehealth until the end of April, but we urge you to check with your specific plan if you are a new patient. The fields with asterisks are required Your Name* Your Email* Reason for the visit* Mobile Phone Number* Can we communicate with you by text messaging (carrier charges may apply)? YesNo Have you visited our office before? YesNo Date of Birth* Insurance carrier* Insurance ID* Address* City* State* NYALAKAZCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMONDNJOHOKORPAPRRISCSDTNTXUTVTVAWAWVWIWY Zip Code* Preferred Appointment Date Available during which hours? (hour only in military time. I.e. 2 PM is 14) From: To: Any additional information you want us to know about (please avoid sensitive medical details)