This is a quick and easy form that gives us what we need to set up your account. You will be able to choose your Provider, request access to the online portal and review our payment and privacy policies. The form will take you less than 5 minutes! If you prefer you can call us directly at 802-878-8131 or fill out the PDF paperwork on the Forms page.

To provide you with the most comprehensive care possible, it is helpful to have a complete health history available at the first visit. Alternately, if you choose to sign up for our Patient Portal after your first visit with us, you may enter all of your health history directly into our Medent Electronic Health Record.

Or, complete your Health History form on our secure online platform with the links below: