Part 1—Personal & Billing Information
Complete a profile for each individual to be included on your family’s billing account on the form below.
To add another person, click “Add a Patient” on the second page.
On the form above, click the “Save & proceed to next step” button to submit.
(Do not click “Add more details” that includes a health history)
After completing the above, you will need to complete a health history & a few other forms to finalize your membership.
(click below to get started)
These forms (for each person) will be required prior to scheduling your first visit.
FAQ on Payments
If you are not part of an employer-sponsored benefit, there is a $80 enrollment fee per household. Payment of this fee plus the initial month's membership fee(s) are required before your first visit(s) or start of service. We will not charge your card until your initial visit.
Future, ongoing payments require a monthly automatic payment by card or bank account.
See our full payment policies here.