Ready to enroll as a Bluefire Med patient? Please fill out the secure form below, and someone from our office will contact you. Got questions? Send us an email.
For patients on a mobile device, please click here to enroll.
Please Note: By filling out the enrollment form at this time, you are showing your interest in reserving a spot in the clinic. You will not be charged until we are open and we have verified that you would like to proceed. After filling out the enrollment form, we will review your records and schedule a meet-and-greet at the clinic to verify the doctor-patient relationship is a good fit and BlueFire Med can meet your needs. If both parties agree at that time, then the membership will be confirmed. Please email us at email@example.com with questions. We are happy to help answer any questions to help you decide if direct primary care is the right option for you.