Review, print and complete one, or both of the intake forms below. Also, please attach a current medication list from your pharmacy. Or, drop by in person to one of our 3 clinics to obtain the intake package.

Once completed and returned, we will review your intake package and contact you to schedule a “Meet and Greet” appointment.


The Health Zone  NPLC has had an overwhelming response from those wishing to become new patients. We will temporarily be placing a hold on any new Intakes until such time as we have managed to get through our current waitlist.  Thank you for your interest and we encourage you to contact Health Care Connect at 1-800-445-1822.