Direct Primary Care Enrollment
 
Sign up Today to start using the benefits of Direct Primary Care.
Step 1: Print out the below forms.
Note: Please complete and send both forms to us, as they are both needed to process your enrollment.
New Patient Enrollment Form (pdf)
Right and Responsibilities Form (pdf)
Step 2: Mail, or Fax the forms to...
| Mail: |
|
PeaceHealth Medical Group
Attn: Direct Primary Care
312 SE Stonemill Dr, Suite 160,
Vancouver, WA 98684 |
| Fax: |
|
(360) 750-8071 |
Step 3: You will recieve your ID card within two weeks. Once you have your card you can make your first appointment and start using the benefits of Direct Primary Care.
If you can't access these forms please call (360) 750-8070 or click here to request the forms be mailed to you.
> Return to Direct Primary Care home |
