TEAM Clinics - Register

Getting Started: Create an Account

This contact will receive all communication regarding the patient visits on this account. Patient information will be gathered on the next page.

Organization

First Name

Middle Name

Last Name

Cell Phone

Password

Confirm Password

Note: By providing a telephone number and submitting this form you are consenting to be contacted about your appointments by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.