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New Patient Registration

Please print and fill out the forms below before your first appointment:

SimplyCare Patient Registration

Medical History

Patient Resources Quick Connect

Testimonial

"Dr. Mehta has been my physician for over 10 years. He and his staff provide me with quality care. His nurse practitioners, Elizabeth and Jannyse, are extremely talented and proficient in their care. When I go to SimplyCare, I feel like a family member. The office staff and technicians always greet me by name and are interested in me as a person as well as a patient. I know when I need treatment, that they will be thorough in their diagnosis, run specific tests, and provide a well thought out treatment plan. Professionally and personally they are the best care providers I've had."
- Tony Cicirello

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  • Providers
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  • Patient Portal
  • Policies and Procedures
  • New Patient Registration
  • Immigration Physicals

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