!!!!!IF YOU ARE A GUARDIAN OR PARENT READ THIS!!!!!

This form must be filled out from the patient's point of view.  If you are the parent or guardian or signer of one or multiple patients, please use a unique email address for each patient. Only use YOUR email address for YOUR account. If they do not have an email for the patient or would like to get notifications and have portal access, you may use a + Alias.  For example, if your email is guardian@email.com, you can use guardian+child@email.com. You can use any text after the + and all emails and notifications will be received by the original email address.  This is supported by most major email addresses including GMail, Outlook, Yahoo, etc. You may request your own portal access to multiple patients via our Frontdesk at 4028981113 or hello@vervech.com.