Online Patient Registration

You may access the following secure forms to assist us with your care. Please complete the following forms, and click the “Submit” button at the bottom of each form.

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

Televox Root Site

  • Televox Main Office - 1110 Montlimar Dr. Suite 700, Mobile, AL 36609 Phone: 1-800-644-4266

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