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Online Forms

Vizuri Health Center offers our patient application online so you can complete it in the convenience of your own home.


Please click on the link below to access our patient application*. You are required to provide an email address on this form for online submission. If you do not have an email account, please complete the email field using [email protected].

Completing this application prior to your first appointment, provides us with the history and current state of your health. This allows us to focus fully on your experience as a new patient of Vizuri Health Center. What are your questions, concerns, and goals regarding wellness? We are here to help, so let us know!

New Patient Application Form


*For best results, Internet Explorer is recommended. Please use a desktop computer or ipad (cell phones do not work).

Location

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Office Hours

Our Regular Schedule

Monday:

7:30 am-5:30 pm

Tuesday:

2:30 pm-5:30 pm

Wednesday:

7:30 am-5:30 pm

Thursday:

7:30 am-5:30 pm

Friday:

By Appointment

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Dr. Bill is amazing! He has so much knowledge and truly wants to help all his patients. I believe he is one of the main reasons why I was able to have an all natural child birth."
    Clara R.
  • "Dr.Bill teaches me something new every time I see him."
    Matt S.
  • "DR BILL HAS GIVEN ME MY HUSBAND BACK!!
    THANK YOU DR BILL!!"
    Martha S.