DO NOT USE ANY SLASHES OR DASHES when entering any dates for this system.

This is an official medical record please use your proper name there is a spot for your preferred name

Click YES enter required information and hit submit; if you are in our system your information will appear for verification. If you return to this screen you are not a patient in our medical record system you will need to proceed by clicking NO and complete ALL fields and submit again.

Next a list of forms should appear; if you are registering for a flu vaccine choose Flu Consent, complete all questions and be sure to hit submit. If you are registering for blood pressure, glucose and cholesterol screenings complete the Client Screening Form and submit.

This will complete your registration process you do not have to print any paperwork. Just show up at the clinic with your ID.

Questions call (856) 218-4151