Albemarle Website

Register My Family

Parent/ Guardian first name

Parent/ Guardian last name

Parent/ Guardian gender

Parent/ Guardian date of birth

Cell Phone #

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Password

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Your Kids

First name

Last name

Date of birth

Gender

Add another kid

Add baby on the way!

Baby on the Way

First name

Last name

Due Date

Gender

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Add baby on the way!

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Your Address

Street Address 1

Street Address 2 Apartment, suite, unit, etc

City

State

Zip

Phone Numbers

Mobile

Home *Optional*

Work *Optional*

Your Insurance

Are the registered patients actively covered by a health insurance policy?

Your Insurance

Do you have the insurance card available now?

Credit Card

Your Insurance

Book Appointment

Do you want to book an appointment now?

Contact Us

Please contact us with any questions. We hope to serve your family soon.

Your Insurance

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Your Insurance

Please help us maintain accuracy by uploading a copy of your insurance card. Select a front and back image of your card.

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Your Insurance

Please select your health insurance provider

Please enter the policyholder's information below:

Your Kids

Please select the family member whose insurance you would like to enter first:

If you would like to add insurance for another family member, please click a name below:

Register My Family

Your Kids

Baby on the Way

Your Address

Phone Numbers

Your Insurance

Your Insurance

Credit Card

Your Insurance

Your Insurance

Book Appointment

Contact Us

Your Insurance

Your Insurance

Your Insurance

Your Kids

Upload picture of insurance card