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Henderson – Vegas Interest

Preferred Family Medicine is exploring a future concierge primary care location in Southern Nevada. Please complete this short form to let us know you may be interested. This is not a commitment to join.

Name(Required)

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Email(Required)

Phone

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ZIP Code

City / Area

Who are you interested in membership for?

Myself

Spouse/partner

Child/children

Parent/family member

Employees / business

Not sure yet

How many people may be interested?

What type of care are you most interested in?

Immediately

Within 1–3 months

Within 3–6 months

Later this year

Just researching

What matters most to you?

Would you like to be notified if we begin scheduling meet-and-greet visits?

Yes

No

Consent(Required)

I understand this form is for general interest only and does not establish a physician-patient relationship. I agree that Preferred Family Medicine may contact me by phone, text, or email regarding a possible Henderson / Las Vegas location.

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All rights reserved | Preferred Family Medicine® | Copyright 2026 | This practice does not constitute insurance. This practice provides only the limited scope of primary care as specified in the retainer medical agreement. Specialty and/or hospital care, pharmaceuticals, and testing (labs that are not included, X-ray, Ultrasound, etc.) are not covered by your fee and are your financial responsibility.