Avery Telehealth Forms

Download and print the needed forms below and you can fax them to 866-664-8892 or scan and email them to us using the online contact form below.

  • Drop files here or
    Accepted file types: pdf, jpg, png, jpeg, gif.
    Upload up to 3 forms/files at a time. Must be PDF or JPG or PNG files.
  • This field is for validation purposes and should be left unchanged.