Vero Beach Adult Medicine — Let's Get You Registered

Vero Beach Adult Medicine — Let's Get You Registered

Complete a few quick questions and our team will call you to confirm any remaining details and get you on the schedule to see Dr. Stewart.
Are you 18 years of age or older?
Vero Beach Adult Medicine sees patients 18 and older. Vero Beach Pediatrics sees patients through age 21, so you may still be eligible to register as a new patient there.

Register with Vero Beach Pediatrics →

If you're set on Adult Medicine, we can see you starting on your 18th birthday — feel free to continue filling out the form below.
Legal name

First NameLast Name
Previous name (former, maiden), if different

First NameLast Name
First name used
Date of birth

MonthDayYear
Date
Legal sex
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Home phone same as mobile?
Home phone
Please enter a valid phone number.Format: (000) 000-0000.
Can we call you?
Can we text you?
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Which insurance plan will you be using?
Relationship to guarantor
The guarantor is the person who is financially responsible for your medical services if your insurance does not cover the full amount. This may be different from the insurance policy holder.
Guarantor first name
Guarantor last name
How did you hear about us?
Should be Empty: