INSTRUCTIONS

  • Choose from either the ADULT or MINOR application below
  • Download the form to your computer (Download Adobe PDF Reader (FREE) If Required)
  • Using Adobe PDF reader: open, read, and adhere to all instructions on the application
  • Complete and save the application on your computer
  • Before you submit the application, close and reopen it to ensure the information has saved
  • Upload the saved application using the section below
  • DO NOT UPLOAD ANYTHING ELSE – YOUR MESSAGE WILL NOT BE OPENED
  • Please allow 24 hours for our team to process your application
  • We will contact you at the telephone number you listed
  • If you have any issues please call our office and we will assist you
  • SUBMIT YOUR APPLICATION TO NEWPATIENT@APGHEALTH.COM
ADULT MINOR

Who Should I See?

Undecided or unsure on what type of provider is best for you? Have a look at our providers to learn more about their services.

View Providers

This page is for people interested in becoming patients of APG Health. It allows you to fill out a new patient questionnaire. We will contact you within 24 hours to schedule an appointment. Thank you!

Existing patients should not be using this page.