By clicking on the 'I Agree' button below, you acknowledge and accept that:

TriValley Primary Care is providing the means to request certain routine services for your convenience via this on-line link. With few exceptions, using this service will ensure faster response from TriValley, and will prevent unnecessary calls to you to clarify what you need. So that this may be a good experience for all concerned, there are rules to follow. To proceed further, you must agree to the following rules:

1. I agree to read the instructions on each request form that I use. In particular, I will carefully review the purpose and limitations statements on each form that I use.

2. I understand and agree that the request forms are NOT to be used as a means of dialog (two-way contact) with TriValley physician or office, but merely to convey my request for the specific service, except as specifically noted on that form. If I need to speak with the physician or nurse, I will call the office.

3. I understand that the process of requesting services via these forms have a required waiting period or built-in delay or time allowance for TriValley's response. If I need services more quickly than the wait interval shown on each request form, I will call the office. If it is an urgent matter or an emergency, I agree to seek care at the most available medical facility, including a hospital emergency room or call 911, as appropriate.

4. I agree that I will not use these forms to request services that need immediate attention or where my health may be jeopardized by a delay.

Having read and understanding all of the above, I agree to use the forms for the stated purposes as shown on each form. By clicking the "I Agree" button, below, I affirm my intention to abide by the above rules.