SOL-DPC Email Marketing -

Register with Sol Direct Primary Care LLC

Welcome to the Sol Direct Primary Care LLC registration page. To register as a new patient, please enter your information in the fields below. Please do not use this form if you are already a patient (you have seen any of our practitioners in the past). To set up patient portal access or amend your information, please contact us.

First Name *

Middle Name *

Last Name *

Home Phone Number

Email *

Date of Birth

Gender

Male

Female

Pronouns

she/her/hers

he/him/his

they/them/theirs

other

Race

White

Black

Hispanic

Asian

Native American

Mixed/Other

Ethnicity

Hispanic or Latino

Not hispanic or latino

Other

Home Address

Which of our services are you interested in?

Primary Care

Medical Weight Loss