New Patient Registration
Get started in a few minutes.
Complete your registration online before your first visit. The form is encrypted and sent securely to our care team.
Registration is open. We'll close the panel when it's full — register now to hold your spot.
Your information is protected. This form uses HIPAA-compliant encryption and is only accessible to our care team. We never share your data outside of your care.
Prefer paper?
Technology isn't always easy.
If you'd rather skip the online form, you can complete these by hand and email them back to our care team. Please confirm you meet all three requirements below before sending.
To register this way, you must be:
- 18 years or older
- Covered by an insurance plan we accept
Email the completed form to careteam@verobeachadultmedicine.com.
Forms & Notices
Privia Medical Group forms & notices.
Vero Beach Adult Medicine is a member of Privia Medical Group. The notices and forms below apply to all our patients — review or download any you need. Your care team can also provide paper copies at your visit.
- View notice →
Notice of Privacy Practices
Describes how your health information may be used and disclosed, and how you can access your individually identifiable health information. Please review this notice carefully.
- Download (PDF) →
Authorization for Release of Medical Information
Allows you to authorize the disclosure of your health information to a designated individual, company, agency, or facility.
- Download (PDF) →
Authorization & Consent for Treatment · Autorización y Consentimiento Para el Tratamiento.
Your consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
- Download (PDF) →
Preferred Contacts · Contactos Preferidos.
Encouraged but not required — lets us know who we may share information with on your behalf.
- Download (PDF) →
Financial Policy
Advises patients of their complete financial responsibility for all medical services received, without regard to insurance eligibility or coverage determinations.
- View notice →
Language Services
Free language assistance and communication aids, with our Notice of Nondiscrimination (English & Spanish).