This form is for new patients only, and should not be completed until you have been contacted by a staff member.
It will take you approximately 20 minutes to complete. If you aren’t able to finish it all at one time you may choose the Save and Continue Later link at the bottom of each page.
If you click the save and continue button and do not get a link in your email, please call our office and we will forward one to you.
PCA Resources, PA is an independent company that provides billing and administrative services to health care providers. All health care providers that use PCA are independent contractors and are not the agents or employees of PCA Resources, PA. Please note that the information contained within this website is provided for informational and educational purposes only. The use of this website does not imply or establish any type of doctor/patient relationship. No diagnosis or treatment is being provided by the use of this website.