Membership enrollment

We are so excited that you’ve decided to join the Peach Blossom family! Please read this page carefully so you understand the process. Membership enrollment involves a few steps:

  1. Click the button below for the membership option you’d like

  2. You will be redirected to the Hint Health Enrollment site - enter your own information on the first page, then select the option “do not enroll me” (as you are enrolling your child[ren] rather than yourself; please note, if you’re enrolling a new baby prior to birth, it’s okay to use a placeholder name and the due date when completing the enrollment, and you can choose to have the membership start at a later date)

  3. There will be three forms to complete linked within the enrollment process and completed in the IntakeQ platform - please enter your child’s name on the login screen (even where it asks for your name).

    • The Patient Agreement (one per family)

    • The Consent for Release of Information (if you would like us to obtain your child(ren)’s records from your previous provider - one per family)

    • The New Patient Intake Form (one for each patient, click the link multiple times if needed - change any answers that automatically pre-fill for subsequent patients)

  4. Once you’ve completed the New Patient Intake form(s), you will receive an email containing the members-only phone number and website login information - please save these for your records, but do not share them with anyone

You can return to this page for reference at any point during the process. If you get stuck, send a message or call (470) 203-0006.