Enter family's login info
User ID:

Please fill in with alphabets.
Personal Information
**Required Information
Company Information
Insurrance Policy Holder
Same as Personal Information
Emergency Contact
Same as Personal Information
Authorization for Information Disclosure and Insurance Payment Process
I authorize to disclose my health information obtained by the diagnostics, treatments and as the result of examination to the insurance company. I authorize to process the claim to the insurance company and payment to be made directly to the clinic to cover the fee of medical treatment that I receive. I also agreed to pay any fee not covered by the insurance to the clinic or the doctor in the timely manner.