Create Profile 6/23/2024 7:40:47 PM | Map Location | Program Expiration:
Only established patients of Alternity Healthcare, LLC and future patients who are ready to begin the intake process should create an account. This will establish you as an online user and allow you to enter and update your profile, make online appointments, purchase supplements and medications from our online store and download our intake forms.
Login Information
User Name
Re-enter Password
Username should be a minimum of 6 characters and is NOT case sensitive. Passwords must be at least 8 and maximium 15 characters long and include at least one letter, and at least one number and not include any special characters. Passwords ARE case sensitive. Please choose your username carefully as you will not be able to change it after initial creation.
Billing Person Administration
If someone other than patient will be financially responsible (Billng Person), click the button below. Before clicking this button, note that the Billing Person must have previously completed this registration page. If you have any questions about using the Billing Person capability, please contact the office that you are registering with.
Personal Information
First Name Middle Name Last Name
Suffix [?]
Primary Phone
Secondary Phone
Billing Phone
Leave Voice Mail [?]
Leave Voice Mail [?]
Leave Voice Mail [?]
Date of Birth Sex SSN
Email 1 Email 2 Race
Marital Status Time Zone
How did you hear about us Location
DL Lic.
Address Information
Billing Address Line 1
Billing Address Line 2
Billing Country
Billing State
Billing City
Billing Zip Code
Shipping Address line 1
Shipping Address line 2
Shipping Country
Shipping State
Shipping City
Shipping Zip Code