Monday-Friday 8am-8pm
Saturday-Sunday 9am-5pm

1300 S Bowen Rd, Suite A
Arlington, TX 76013
817-704-1444

Rehoboth IV Infusion Patient Registration

Rehoboth Urgent Care IV Infusion Registration

Register to sign in for IV Infusion at Rehoboth Urgent Care

Step 1 of 4

Patient Information

Name(Required)

First Last

Date of Birth(Required)

Gender(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

ID (FRONT)

Max. file size: 300 MB.

ID (BACK)

Max. file size: 300 MB.