Patient Talker Beta Signup
Thank you for your interest to learn more about Patient Talker. We're here to help organize your doctor visits and empower you to be more in control of your own healthcare.

By using this pre-release software, you'll be able to get an early look at where things are headed. We also very much appreciate your feedback.

After you submit this form, please allow 1-2 business days for your request to be reviewed. Once approved you'll receive an email with instructions for how to use the Patient Talker app.

Thank you,
Fred (Patient Talker LLC founder)
Sign in to Google to save your progress. Learn more
Email *
First and last name? *
Date of Birth (Note: you must be 18 or older to use this version of Patient Talker) *
MM
/
DD
/
YYYY
Country of residence (Note: you must be a US resident to use this version of Patient Talker): *
Are you a Health Care Professional?
Clear selection
Consent: I understand this is pre-release software that I am being given access to in order to help test and better understand its capabilities.

While best efforts have been made to ensure the stability, privacy, and security of this software - there are likely to be errors, bugs, and unexpected behaviors.

[Note: this is not meant to scare you - just to warn you that at this stage, use of this product is for testing and should not be relied on to replace any discussions with a health care provider]

Please read our Privacy and Terms of Use policies.
*
Required
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Patient Talker LLC.

Does this form look suspicious? Report