Register with Carpathia Collaborative

Welcome to the Carpathia Collaborative registration page. To register as a new patient, please enter your information in the fields below. Please do not use this form if you are already a patient (you have seen any of our practitioners in the past). To set up patient portal access or amend your information, please contact us directly.

If you are already a registered patient with online access, you can log in here.

Once you have registered and are able to login using the username and password you’ve selected, please click on "Questionnaires" in the right hand column to fill out the necessary forms. Fill out all the New Patient Forms under “Intake Forms” and “Policy & Consent Forms” and any others that you’ve been instructed to complete. Please select which practitioner you'd like to see at the top of the main "Medical History" questionnaire. If you don't know which practitioner you'd like to see, select "I do not know". We will review your paperwork and assign you to the practitioner most fit to address your specific health concerns, then call you promptly within 24 - 48 hours to schedule an appointment. Please upload into the Patient Portal or bring with you to your first appointment any previous labs and procedures, or we may request that you get some lab work done before coming in.

You are welcome to call us to schedule an appointment before paperwork is complete, but we do ask that you complete all paperwork no later than 48 hours before your scheduled appointment. This allows us adequate time to review your information in order to understand your condition and how best to guide you back to optimal health.

For questions or to schedule an appointment directly, please contact Carpathia Collaborative admin at 469-729-6460 or by emailing Admin@carpathiacollaborative.com. Thank you!

Basic Contact Information

Your Address

Contact Information

Emergency Contact

Insurance Information

Note: Our practice does not bill insurance, but this information makes it easier for us to refer you for other services (like labs or specialists). We will, upon request, provide you with forms to submit to insurance on your own behalf.

Medical Information

Please enter your basic medical information below. You may also add or edit this information after you've signed up.

Set Username and Password for Patient Portal

Please create a username and password that you will use to log into the patient portal in the future.

Your username must be at least 4 characters long

Your password must be at least 8 characters long and include at least one number or special character.

The patient portal gives you access to your medical records and lets you securely communicate with your doctors. When you sign up, you will receive an email with instructions for logging in.

Patient Portal Powered by MD HQ, LLC © 2017