Doctor Registration

Section One - Demographic Information

Section Two - Contact Information

Office Contact Information

Section Three - Practice Information

Solo Group(2+) Academic Hospital Based
Fee for Non-Covered Service Mode
Fee for Care Mode
Cash Only
Maximum Limit of No. of Patients in Practice
Hybrid Mode(mixture of insurance only and direct practice)
% of practice revenue directly from concierge/direct practice patients excluding insurance payments

Section Four - Create User Name and Password