MedWorks — Healthcare Without Borders

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Care Requested

Country of Care *

Type of Care *

Booking Agent

Name *

Email *

Phone

Insurance Company *

Guarantee of Payment (GOP)

Optional now — PDF / JPG / PNG / WebP, max 10 MB. The appointment will remain pending review until a GOP is received (attach here, or email it to corpbooking@medworks.com later referencing your booking number).

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Patient Information

First Name *

Last Name *

Email *

Phone *

Date of Birth *

Policy / Reference Number

Patient Location

Street Address *

City *

State / Region *

ZIP / Postal Code *

Country (if different)

Schedule & Reason

Requested time is not guaranteed and is subject to availability.

Available hours: 9:00 AM – 5:00 PM EST. Same-day appointments available with at least one hour notice.

Your Timezone

Select Date

August 2026

Select Time

Pick a date first to see available times.

Reason for Care / Symptoms *

Mark this booking as urgent

I confirm I am authorized to book this appointment on behalf of the patient and the insurance company named above, and I understand that the appointment will not be confirmed until a Guarantee of Payment (GOP) is received.

Consent & agreements

I agree to the Terms of Service and Privacy Policy.I consent to MedWorks collecting, using, and disclosing my personal health information to coordinate and facilitate my healthcare appointments with network healthcare providers, including sharing relevant health records with the clinic or provider I am booking with.I additionally consent to MedWorks sharing appointment records and clinical notes with my insurance provider where applicable, for the purpose of claims processing and benefit coordination.

I understand that my information may be accessed by or shared with healthcare providers and insurance providers within the MedWorks network. I may withdraw consent at any time, which may affect MedWorks's ability to provide coordination services. For full details, see our Privacy Policy.

I confirm I have the authority to share this member's health information and agree to MedWorks' Business Services Agreement .

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Book care as a provider for your member

Care Requested

Booking Agent

Patient Information

Patient Location

Schedule & Reason