PLEASE REVIEW THE INFORMATION BELOW BEFORE MOVING ON TO THE NEXT STEPS.

• Please allocate 20 to 30 minutes to complete all necessary steps for scheduling appointments with our office.

• It is important to note that all steps must be completed online. If you do not have access to the internet, we invite you to visit one of our offices to utilize a laptop.

• Please ensure that you allocate sufficient time to complete all forms and maintain a stable Internet connection. Progress cannot be saved during the registration process. If you experience a loss of Internet connectivity or attempt to save your progress, you will need to restart and re-enter all information.

• If the patient has ever had an appointment, had a referral sent over, or taken steps to establish themselves as a new patient at AAPSA, please select ‘Yes’ on the next screen when asked ‘Would the patient’s information be in our system’. If you are uncertain, we encourage you to select ‘Yes’ on the next screen to attempt to locate an existing account. If no account is found, please click ‘Back’ and select ‘No’. 
• It is important to note that if the submitted forms are not fully completed, we will be unable to process your request for services. Additionally, the completion of these forms does not guarantee acceptance of your case. A decision will be made based on a clinical review of your needs and our office’s current capabilities.
• Please be aware that Patients aged 18 and older must complete the intake forms themselves. If you are completing this intake for someone 18 years or older, please have their direct contact information available to enter prior to moving forward.
• If you are wishing to refer one of your patients to our office, please do not complete this form. Referrals can be faxed to us at (866) 822-2343. Patients will still be required to complete the registration process.