Registration Instruction

Welcome to the secure new-patient registration form. Please use the following instructions to help in filling out the form:

  • Please complete all fields highlighted in green; other fields are optional (note: 'Client' is the patient).
  • If you will be using insurance, please check the 'Insurance' box (in middle of form).
  • If you prefer to pay out-of-pocket and will not use insurance, please check the 'Self Pay' box.
  • When finished, click 'Save'

Palo Alto Mind Body
550 Hamilton Avenue, Suite 240
Palo Alto, CA 94301
Phone: 650-681-2900
Office Hours

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