UBERDOC - Sign Up

Become an UBERDOC Patient

You must be 18 years or older to use UBERDOC. If you are scheduling an appointment on behalf of someone (child or elderly parent) please use your own information here.

First name*

Last name*

Email*

Confirm email*

Password*

Re-enter password*

Phone number*

Gender *

Date of birth *

Street address *

Street address 2

City *

State *

Zip code *

How did you hear about UBERDOC? *

I have read, understand and agree to the UBERDOC Privacy Policy

I have read, understand and agree to the UBERDOC Terms of Use

I understand my health savings account or credit card will only be charged upon scheduling and/or completing an appointment.