Patient Registration Form

Convenient Online Registration

TrustCare is going paperless in order to streamline our check-in procedure at our clinics and reduce your waiting time. Please click the button below to input your information. You may submit this information prior to arriving to a TrustCare clinic, or you may be encouraged to fill out the information upon arrival.

New Patients: You can do all of your paperwork online, including taking a picture of your driver’s license and insurance card. This will create you as a patient in the TrustCare system and save you time at the clinic or on a Telehealth call.* 

Existing Patients: Please fill out this form only to make sure we have your latest information. Otherwise, it will automatically pull all of your info as we have it already recorded in our system. This will save you time at the clinic or on a Telehealth call.*

Patient Registration Form

*More information on our Telehealth platform is available here.