Step 1 of 5

Start your intake

Complete the form below to begin. Your information will be reviewed before your telemedicine evaluation.

Not sure if your condition may qualify? Review condition examples for New York or Connecticut, start your intake, or contact BuddMD with general questions before beginning.

Questions before starting? Phone/Text (347) 822-9973 or email [email protected].

✓ 100% refund if certification isn't clinically appropriate.

Full name

Date of birth

State of residence

Street address

City

County

ZIP code

Is this a renewal or your first certification?

Phone number

Email address

Condition / relevant medical information

After you submit this form, your information will be reviewed. You may be contacted if additional information is needed. ID verification may be requested after intake — please do not email sensitive documents unless specifically instructed.

Certification is provided only if clinically appropriate and is not guaranteed. BuddMD is a cash-pay service and does not bill insurance. If certification is not clinically appropriate and payment was collected for the certification service, the payment will be refunded.

Schedule your telemedicine visit

Choose a convenient appointment time after submitting your intake.

Schedule Visit

What happens next

Physician review

Your intake is reviewed before your evaluation. You may be contacted if additional information is needed.

Telemedicine evaluation

Complete your evaluation remotely. No office visit required.

Certification

If clinically appropriate, your certification is submitted according to your state's process.