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Cervical (neck)
Lumbar (low-back)
Lumbar Herniated Disc
Thoracic (mid-back)
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Hemifacial spasm
Glossopharyngeal neuralgia
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Brain
 
 
     
 
Create a New Patient Account

Step 1

Please create an account by filling out the form below. You will then be directed to our New Patient forms to complete the initial process of becoming a patient of Dr. Clyde. Once an account has been created, you may save any unfinished forms and return to your account at anytime to complete them. After you have seen Dr. Clyde for an appointment, or had an online virtual consultation completed, you are considered an existing/established patient and will have access to other features of eBrainMD.com.

If you have any questions regarding any of our online forms, features, or use of this website, please call us at (801) 295-2438.

 
Patient Type:
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Date of Birth*: MM/DD/YYYY
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