Please note that once this form is submitted, additional information must be obtained by our staff to fully register a new patient with our practice.

A HarmonyCares Medical Group office representative will contact you by phone or email within 1-2 business days to complete the registration process.

For immediate assistance regarding a current HarmonyCares patient, please contact the patient’s HarmonyCares office.

Disclaimer: Because e-mail sent to and from this site may not be secure, you should take special care in deciding what information you send us via email.