Here at Synergize Direct Primary Care, we try to make life (and your healthcare) as simple and easy as possible. Complete this form below to enroll online, so your first visit with us won't be inundated with tons of paperwork. You can just check in, sip a cup of coffee (or tea) and have a seamless, enjoyable visit with your doctor.
After you enroll, we will call/e-mail you within 48 business hours to complete the final steps of your enrollment and set up your first appointment.
Or, if you still have questions, please contact our office: 215-876-0360.
*Your credit/debit card information is required for enrollment. You will be charged the one-time enrollment and monthly membership fee only after you speak directly to a member of our staff.
*Please click "FULL SCREEN" to have the best experience with enrollment*.
PLEASE BE ADVISED THAT YOUR ENROLLMENT BELOW ADDS YOU TO OUR WAIT LIST AND YOU SHOULD EXPECT TO BE SEEN AS A NEW MEMBER WITHIN 2-4 WEEKS.
Fill out all applicable fields in the enrollment form panel to complete your registration process. If you are unable to see any information in the enrollment form panel, or the information appears to be displayed incorrectly, try refreshing your web browser to reload the form. You may also load the enrollment form as a full page document by clicking the “open in fullscreen” button present in the form panel.