Request an Appointment

Northlight Health — Telehealth for Florida

Please correct the errors described below.

Use this secure form to request an appointment. Northlight will contact you within one business day to confirm your visit. This form is for scheduling only and does not provide medical advice.

Client Information

How can we help?

A short description helps us schedule the right visit. Each option is private, secure, and tailored to your needs.

  • Primary Care – Colds, sinus issues, allergies, rashes, UTIs, and similar concerns.
  • Mental Health Consult – Anxiety, sleep, stress, or mood concerns. Not a therapy service. Northlight does not provide ADHD evaluations, controlled‑substance visits, or crisis care.
  • Chronic Condition Check‑In – Diabetes, hypertension, thyroid, asthma, and similar conditions.
  • Medication Refill (non‑controlled)
If selecting “Other,” please describe your concern briefly. Northlight does not schedule therapy, crisis care, disability paperwork, FMLA, ESA letters, or controlled‑substance visits through this form.

Preferred Contact Method for Scheduling

Health Insurance Plans

“If your plan requires a PCP selection, please ensure Northlight is listed.”

If you’re unsure whether your plan is active, choose “Other / No insurance.” We’ll verify coverage for you. Self‑pay visits are $45.
“If you don’t have your card handy, you may leave this blank. We will review your information and contact you if anything else is needed.”

You’ll upload your insurance card after your appointment is scheduled.

By submitting this form, I understand this form is for scheduling only and does not establish a patient‑provider relationship or provide medical advice until my appointment is confirmed.

Northlight provides secure, encrypted telehealth care for Florida residents. Your information is protected and never shared without your consent. Northlight never shares your information with third parties for marketing or advertising.

Your information will be encrypted.

Trusted care, built to fit real life.

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