Get an account with Conex

If you wish to get a telemedicine account so that you may communicate with Dr. Poole please fill out the following fields. After completeing this form you will be given an account to login to the Conex System.

Create Account

*Note: All fields marked with an asterisk (*) are required.

*First Name*MI*Last Name*Street Address*City*State*Zip Code*Telephone Number*Email AddressReferred ByPreferred Communication Method

Phone Text

Email

Phone Call

Cellular Phone Carrier (Verizon, AT&T, etc.)

Required