top of page
Image by Bermix Studio

Sign Up for
New Members

Join today with two easy steps to have Patient Sortal manage your healthcare needs

ND PS Logo.png

PS

Pennsylvania
New Member Enrollment Form

Step 1: 

Step 1: Please fill out the following health declaration form in order to participate in our activity. Submissions are valid up to 24 hours prior to the activity.

Please note North / South/ East/ West of facility. 

arrow&v

Thanks for submitting! Please move to step 2!

Step 2: 

Step 2: Click Button below then, Fill out and Sign Patient Sortal HIPAA Right of Access. This document allows us to manage our Members Health Records. This form must completed, signed, and emailed to contact@patientsortal.com upon completion

Member Card

Step 3: 

bottom of page