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Start Assessment

Step 1 of 6

Welcome to QliqHealth

ADHD, mental health, weight management, and hormone management begin with a video visit. Complex, chronic conditions and cancer support may take up to 48 hours for a visit or response.

I confirm I do not have Medicaid/Medical. I understand that QliqHealth is not for emergencies. If I am experiencing a medical emergency, I will call 911 or go to the nearest ER immediately.

Seek emergency care immediately for symptoms such as chest pain, stroke symptoms, severe shortness of breath, thoughts of harming yourself or others, or any life-threatening condition.

I agree to the Online Care Terms of Service and Privacy Notice. I acknowledge and agree that prescriptions are Not guaranteed and are provided when clinically appropriate and permitted by applicable state law.

Entry Path

How would you like to get started?

Choose one option. The form adapts automatically based on your selection.

Provider Visit

Starting at $79

Secure Messaging Recommended
Connect directly with a provider through secure messaging, phone, or video.

Talk with a Nurse Practitioner.
✓ Video
✓ Phone
✓ Text
✓ Full evaluation and care discussion

Includes:
✓ Full provider evaluation
✓ Diagnosis and treatment recommendations
✓ Prescriptions when clinically appropriate
✓ Lab orders and review
✓ Follow-up recommendations
✓ Clinical Care Review credit applied when eligible

Best for:
New symptoms
Medication management
ADHD care
Weight management
Hormone health
Ongoing primary care

Clinical Care Review

$29

Not sure what type of care you need? Start here.

✓ Review of symptoms and history
✓ Provider assessment of the appropriate next step
✓ Guidance on whether a full visit is recommended
✓ $29 credited toward a $79+ Provider Visit when booked within 7 days of the clinical review

The $29 Clinical Review fee is non-refundable because provider time is spent reviewing the submitted information and determining the appropriate care pathway.

Ask Provider

$20

Get a clinical answer from your Nurse Practitioner.

For medication questions, symptoms, labs, side effects, or quick medical clarifications.

Patient Instruction:
Before submitting, please gather your questions into one message so your provider can review the information efficiently and respond in one structured clinical response.

$20 per clinical question / approximately 15-minute review block.

One submission = one clinical topic.

Examples:
✓ One symptom update
✓ One medication question
✓ One lab question
✓ One side-effect question
✓ One follow-up clarification
✓ One administrative medical question

Not intended for:
✕ Ongoing back-and-forth messaging
✕ New diagnoses requiring a full evaluation
✕ Complex or changing symptoms
✕ Multiple conditions
✕ Emergency concerns

Future pricing can accommodate multiple-question review blocks without changing the underlying structure.

QliqHealth Membership

$29–$49/mo

For patients who want ongoing care, continuity, and priority access.

Benefits & Savings:
✓ Reduced visit fees
✓ Priority messaging
✓ Ongoing care plans
✓ Medication monitoring
✓ Follow-up support
✓ Continuity care

Future Expansion:
Priority care
Chronic care programs / RPM
Employer plans
Family plans

Secure & confidential.
Patient data is captured in a structured, Webflow-ready layout.

Care Need

What do you need help with?

Select the option that best matches your care need.

Appointment Type Mandatory

Symptom severity

Reason for visit Mandatory

**Please describe your main reason for today's visit, including when it started, any treatments you've tried, and how it's affecting you. If applicable, include when you last had your annual physical, lab work, dental exam, vision exam, or skin check. Any recent ER/ Urgent Care visits and or hospitalizations? The more details you provide, the better and quicker your provider can evaluate your needs**

0 / 75 characters (minimum required)

How did you hear about us? Mandatory

Document upload optional

Upload Labs blood work, reports Upload Imaging X-rays, MRI, CT Prescriptions current meds

Health Background / History

Your health background / history

A focused baseline helps the provider review your concern more accurately. All fields must have an entry

Height Mandatory

Weight Mandatory

Blood pressure Mandatory

Heart rate Mandatory

Known allergies Mandatory

Current medications Mandatory

Past Medical Conditions Mandatory

Recent ER / hospital visits?

Preferred pharmacy Mandatory

If yes, provide details

Pharmacy location Mandatory

Patient Details

Tell us about yourself

Basic information needed to safely review your request.

Full name Mandatory

Date of birth Mandatory

Email address Mandatory

Phone number Mandatory

State Mandatory

Care Delivery Preference

How would you like to receive care?

This step appears for provider visits only.

Preferred time window 1 Mandatory

Preferred time window 2 Mandatory

Review & Payment

Review your information

Payment must complete before the request is submitted.

Entry PathProvider Visit — Secure Messaging Recommended

$79+

Patient DetailsNot entered yet

Health Background / HistoryHealth background captured

Care NeedCare selection, concern and uploads captured

Care Delivery PreferenceSecure messaging / phone / video preference captured

Total

$79+

All fees shown before you submit and pay.

Request-Based Care

Prescription Refill Requestwith licensed-provider review before approval. $39

Lab Order Requestwith provider review; laboratory fees are separate. $59

Medical Question $20

Lab: Not sure which tests you need? Book a full provider visit for evaluation and personalized guidance.

Full Provider Visits

Urgent / Sick Visit $79

Follow-up $80

Initial / Specialty Visit $99–$125+

Complex / Chronic Care $199+

Primary care

Annual physical $125

Urgent Care / Sick Visit $79

Medical Documents / Forms $49

Prior Authorization $49–$75

ADHD care

Initial intake $125

Initial treatment visit $99

Treatment / follow-up $80

Weight management

Initial $125

Follow-up $80

Hormone health / HRT

Initial $125

Follow-up $80

Chronic and complex care

Visit range $199–$249

Cancer support and Repurposed drugs $199–$365

Membership $39–$59/month

Medical question per topic $20

Clinical care review $29

Payment & Refund Policy:

Payments for Medical Questions, Clinical Care Reviews, Clinical Intakes, and completed clinical services are non-refundable once the service or review has been provided.

Cancellation & No-Show Policy:

Appointments may be rescheduled without a fee up to 48 hours before the scheduled appointment. Cancellations or rescheduling requests made less than 24 hours before the scheduled appointment, as well as no-shows, will incur a $50 fee. The $50 fee is non-refundable.

Clinical Intake Credit:

If a patient books a full Provider Visit within 7 days of the clinical review of their intake, the applicable Clinical Review/Intake fee will be credited toward the Provider Visit.

Reserve your appointment with a $79 booking fee. If you select a specialty consultation (Cancer Care, Hormone Health, Weight Management, ADHD, or Anxiety/Depression/OCD), any remaining balance will be confirmed and collected before or during your visit.

ADHD, mental health, weight management, and hormone management begin with a video visit. Complex, chronic conditions and cancer support may take up to 48 hours for a visit or response.

I acknowledge and agree that prescriptions are Not guaranteed and are provided when clinically appropriate and permitted by applicable state law.

Good news! Your visit request has been received and is now under clinical review.

We will send you a secure payment link. Once payment is completed, your visit will continue via secure message, phone, or video call. Your Lead Nurse Practitioner will personally review your case. Your treatment plan or next steps will be available within 2–48 hours. We'll notify you as soon as your review is complete.

Please check your spam or junk folder if you don’t see our message in your inbox.

Complete your payment to start your visit

Pay Now

Secure payment via Stripe

Thank you for choosing QliqHealth. Care Connected. Life Uninterrupted.

Primary Care

Weight Loss

Hormone Health

ADHD Care

Primary Care Telehealth

Documents & Forms

FAQ

About Us

AZ . CA . FL . NY . OR . WA

Privacy at QliqHealth
QliqHealth protects your personal and health information with appropriate privacy and security safeguards. We use your information to provide care, coordinate services, process payments, and communicate with you.

AI & automated tools may support intake, care requests, messaging, and administrative tasks. All care requests and completed intakes are reviewed by a licensed, board-certified, experienced medical provider—including physicians, Nurse Practitioners (NPs), and Physician Assistants (PAs)—before a treatment plan is provided.

When additional care is needed, we may coordinate messaging, phone, video, in-person visits, or referral to the appropriate specialist or level of care.

Your privacy matters. We do not sell your personal or health information for marketing.

Terms. Privacy. HIPAA Notice

+1 (831) 275-0223

Welcome to QliqHealth

Important Care Information

How would you like to get started?

Provider Visit

Clinical Care Review

Ask Provider

QliqHealth Membership

What do you need help with?

Your health background / history

Tell us about yourself

How would you like to receive care?

Review your information

Good news! Your visit request has been received and is now under clinical review.

Services

Support

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