All new patients must fill out this online enrollment form at least 1 day prior to your appointment day.
When you are ready to be a member, enrolling with EMPOWER Direct Care is easy.
This Online registration form will take approximately 10-15 minutes to complete and will require your medical history information. No payment will be due until after enrollment is finalized. After the form is completed and submitted, we will contact you to finalize your enrollment. You will be able to make appointments to discuss medical conditions after signing up. We will never share your private information. If you have any questions about enrollment, please contact us.