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Getting Started Is Easy

Schedule your appointment.

Choose the option below that fits your situation. Most new patients are seen within 24-48 hours.

Established Patients New Patients
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For Current Patients

Established Patients — Book Online

Already a MyPremierMD patient? Use our secure patient portal to schedule your next appointment in just a few clicks — see real-time availability, choose your preferred provider, and get instant confirmation.

Book Your Appointment Now

Prefer to call? (908) 450-7002 — our team can book your appointment over the phone in under 2 minutes.

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New to MyPremierMD

New Patient Registration

Complete this form and our team will contact you within one business day to confirm your appointment and verify your insurance. Required fields are marked with an asterisk — everything else can be left blank if it doesn't apply to you.

1 Personal Information

2 Contact Information

3 Reason for Visit

e.g. "Annual physical" or "Anxiety and trouble sleeping for the last few months"
If you'd like us to coordinate with your other providers, list name, specialty, and location.

4 Health Insurance

5 Medical History

Leave any of these blank if they don't apply to you.

6 Lifestyle

Helps us understand health risk factors. Leave any of these blank if they don't apply to you.

7 Family & Preventative History

8 Sexual Health

Sexual health is an important aspect of general health. These questions help us provide complete care.

9 Mental Health Screening

Over the last 2 weeks, how often have you been bothered by the following?

If you're having thoughts of harming yourself right now, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

10 Mental Health Background

Have you been given any psychiatric diagnoses? If yes, list them.

11 Medical MJ Consent

New Jersey's Medical Marijuana Program requires a specific consent for certification. Reviewing and agreeing here does not itself certify you — our provider will discuss your eligibility at your visit.

12 Additional Information

14 How Did You Find Us?

You can also call us directly at (908) 450-7002 for immediate assistance.

Thank you! Your registration has been received and is on its way to our clinical team. We'll reach out within one business day to verify your insurance and schedule your first appointment.
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