Thank you for your interest in becoming a registered member of As a registered member you will be able to request and receive medical opinions from American physicians and receive periodic health and fitness tips by email. If you would like to join our membership, please fill out this application form and choose a login name and password for your future visits.

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New Patient Registration

Please fill out the following form:

Title:   Mr.   Mrs.   Ms.   Dr.
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Sex:   Male     Female

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Please choose a Login Name and Password that you will use for future visits to

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