Patient Registration

Step 1

Please reserve your spot at one of our urgent care locations by clicking here. All reservations can be made for any and all services our urgent care provides.

Please note: Our reserve your spot is an estimated time that you will be seen once your registration has been completed. Please note patients with a critical conditions may be seen ahead of you and we take all walk-in patients as well.

Step 2

Fill out our online patient registration form when you check in. This is to ensure a smooth registration process for all of our patients and to gather the necessary information required for your visit.

Step 3

Your patient paperwork can be filled out ahead of time. Download the forms you need at the urgent care location you are visiting. Click Here for a list of locations. Please know there is no need for you to do this as we have all forms available in-house for you, but if you’d like to fill them out ahead of time you are more than welcome.

Step 4

Please be sure to bring or have the following pieces of information with you prior to your visit with us:
Driver’s license or photo ID
Insurance information
Payment for copay or self pay
List of medications, allergies, past surgeries
Parental Authorization Form (for minor without parent present)
If you insurance has a deductible or coinsurance, you will be sent a bill for the adjusted charges for the services rendered

For Current Patient:
If your insurance has changed, you will need to present your new card for verification.
If it has been some time since you last visited our facility, you may need to fill out some forms and present a current photo ID.

If you are unsure of your coverage specifics, please contact your insurance carrier directly for information regarding your visit and network benefits.

Please Select the Appropriate Location Form:

Brick Patient Paperwork
Manalapan Patient Paperwork
Paramus Patient Paperwork
West Caldwell Patient Paperwork
Midland Park Patient Paperwork