Concierge Medicine Membership Registration Form

Streamline Your Concierge Medicine Practice with Paperform

Concierge medicine represents a new standard in personalized healthcare, and your patient registration process should reflect that premium experience. This concierge medicine membership registration form template helps medical practices deliver a seamless onboarding experience while gathering essential health information, membership preferences, and contact details in one elegant form.

Built for Modern Healthcare Practices

Whether you're launching a new concierge practice or expanding your membership base, this template captures everything you need: membership tier selection with transparent pricing, comprehensive wellness baseline assessments, emergency contact information, and 24/7 access preferences. The form adapts to each patient's responses using conditional logic, ensuring they only answer relevant questions.

Paperform's healthcare-optimized features make it ideal for medical practices that prioritize patient experience. Accept membership payments directly through integrated payment processors like Stripe or PayPal, automatically send personalized welcome emails with access credentials, and sync new patient data directly into your practice management system or CRM.

Automate Your Practice Workflows with Stepper

Once a new member submits their registration, Stepper can automatically trigger your onboarding workflow: create patient records in your EHR system, schedule their initial comprehensive wellness visit, send membership welcome packets, provision their 24/7 telehealth access, and notify your care team—all without manual data entry.

Secure, Compliant, and Professional

With SOC 2 Type II compliance and robust security features, Paperform helps you maintain the professional standards your concierge patients expect. Customize the form's design to match your practice's brand, embed it seamlessly on your website, or use it as a standalone landing page. Over 500,000 teams worldwide trust Paperform for their critical business workflows.

Start delivering the premium registration experience your concierge medicine practice deserves.