Register Online

To register as a patient, fill out the form below.

Note: You must allow pop-ups on this page to complete the online registration.
Please click on the ‘Save’ button after filling out the form. You will not be able to edit the data on this form once it is saved. Please contact us at (775) 448-9760 in order to make any changes once the data in the form is saved. Once the data is saved you will be redirected to a confirmation page where you can print the next set of forms for completing the Clinical intake.