New Patient

Who are you, and why are you here? That's all we need to start.

Coming Soon

Patient registration is not yet open. Authentication and multi-user support are on the roadmap. For now, existing patients can be accessed from the home page.

Who Are You

First Name*

Last Name*

Date of Birth*

Gender*

Why Are You Here

Chief Complaint*

Authorization & Consent

Notice of Privacy Practices

PatientZero ("the Platform") collects, stores, and processes your Protected Health Information ("PHI") including but not limited to: medical imaging (DICOM), laboratory results, clinical notes, prescriptions, and demographic information you provide.

How we use your data:

To display, organize, and analyze your health records within your personal workspace.
To generate AI-assisted analysis and insights based on your uploaded data.
To enable collaboration between you and your chosen healthcare providers within a shared workspace.

How we protect your data:

All data is encrypted in transit (TLS 1.2+) and at rest (AES-256).
Access is restricted to authenticated users with workspace authorization.
We do not sell, rent, or share your PHI with third parties for marketing purposes.
AI processing uses your data only within your workspace context and does not train external models.

Your rights: You may request access to, correction of, or deletion of your PHI at any time. You may revoke this authorization in writing. Revocation does not affect actions already taken in reliance on this authorization.

I acknowledge that I have read and understand the Notice of Privacy Practices.

Consent for Data Use

By checking below, I voluntarily authorize PatientZero to collect, store, and process my Protected Health Information as described in the Notice of Privacy Practices above. I understand that:

This authorization is voluntary — I am not required to sign as a condition of treatment.
I may revoke this consent at any time by submitting a written request.
Data uploaded here is stored in a cloud-hosted database (Supabase, hosted in the United States).
This platform is for personal health advocacy and research — AI analysis does not constitute medical advice or clinical diagnosis.

I consent to the collection and processing of my health data as described above.

AI-Assisted Analysis Disclosure

This platform uses artificial intelligence to analyze medical data including imaging, laboratory values, and clinical documents. AI-generated insights are informational only and are not a substitute for professional medical judgment, diagnosis, or treatment. Always consult a qualified healthcare provider before making medical decisions.

I understand that AI analysis is supplemental and does not replace professional medical advice.

By signing below, I confirm that the information provided is accurate to the best of my knowledge and that I have read, understood, and agree to all terms above.

Patient Signature

Sign above the line

Use your mouse, stylus, or finger to sign above

Date: Sunday, March 15, 2026

After intake, you'll land on your patient hub — drop everything there.