Heritage Membership Sign-up Heritage Membership You Are On Your Way To getting a health care provider partner who will look after your well being every step of the way with coordinated care. You will also receive all the high-quality benefits of being a Heritage Medical Group member! Fill out and submit this form. We will get in contact with you shortly to initiate your membership. Name:* First Last Date of Birth:* Date Format: MM slash DD slash YYYY Current Health Insurance Company:Phone NumberEmail: How Can We Help You? Check the box to receive a call from us to answer any questions you have. 760-261-6400 or 1-800-655-9999 members@www.hvvmg.com