We Are Excited To Help You...

We just need to confirm your contact information, and give you access to our new patient forms.

Please submit this form and follow the simple steps below

Once we confirm your email, you will get access to our online forms

privacy We value your privacy and would never spam you

  • Step 1: Check Your Email

    Check your email inbox of the account you just used in the form above

  • Step 2: Open Confirmation Email

    Open the email with subject line [New Patient Email] sent from Patient Coordinator <info@maximizedhealth.net>

  • Step 3: Click The Link in the Email

    Click the link inside the email to confirm your details and get access to your forms