New Patient Registration

To schedule a consultation with Dr. Rodriguez, kindly complete the form provided below. Please keep in mind that the form necessitates the submission of your insurance card and picture ID, so ensure you have them readily available for upload. Be aware that the form is quite extensive and may take up to 15 minutes to complete, so plan accordingly.

Rest assured that the form will only be processed upon filling in all the mandatory fields and successfully uploading the required pictures.

Following the form submission, you can expect to receive an email or a phone call from one of our patient coordinators within 1 to 5 days. They will either confirm your appointment with Dr. Rodriguez or request any additional documents if needed.