Enrolling as a new NASH patient is easy.

All new NASH patients must fill out the Patient Information, HIPAA and Informed Consent, and Medical Records Release forms.

All patient forms are HIPAA-compliant and available in English and Spanish. If you have questions before starting enrollment, a good place to start is our frequently asked patient questions (FAQs).

  • To start new patient enrollment,  select the Patient Information Form below.
  • Select the drop-down menu in the right-hand corner of the form to change to your preferred language.
  • Fill out all the fields, click “submit” at the bottom of the completed form. Repeat until all required forms are submitted. 

The NASH Patient Care team will review your submission for completeness and contact you with next steps.

Learn more

Patient Information

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HIPAA Informed Consent

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Medical Records Release

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Patients value their NASH experience
My experience with NASH has been really, really good.
Satisfied NASH Patient
NASH knows what they’re doing! The personnel is great, the expertise is great. You’re well taken care of – it’s just almost like they know what you need before you know what you need.
Satisfied NASH Patient
Satisfied NASH Patient
I cannot say enough good things about the service and support I received from NASH.
Satisfied NASH Patient
Satisfied NASH Patient
I think you get more one-on-one care here. It’s like I was the only patient that they had to take care of.
Satisfied NASH Patient
Satisfied NASH Patient
NASH has been a great benefit … I feel safe and get the exact same medication.
Satisfied NASH Patient

Still have questions?

Our patient care team is on hand to help with all your enrollment questions.

Contact us