# Create patients

Canonical page: https://docs.ovok.com/api/signals-api---patients/create-patients

`POST /v1/signals/api/patient`

Upserts on `refId`: posting a patient that already exists updates it rather than duplicating it, so a replayed provisioning run is safe. Each entry's `config` — flags and triggers — is applied in the same call, and `metadata` is merged.

### Through ovok

- **Who can call it:** Manager apps, and users whose access policy grants the capabilities.
- **Capabilities, all required:** `signals_patients:update`. Project admins have every capability; client applications get no admin bypass.
- ovok adds your project's submitter to each new patient and stamps `metadata.project` with your project. Sending `config` also needs `signals_config:update` and `signals_silence:update`. New patients count toward your plan's monitored-patient cap.
- If your access covers only some patients (anyone but project admins, manager or submitter apps, and anyone whose Patient access has no criteria), every patient the body names must be one you can update. A patient is named by its Signals id, or by its Medplum Patient id where Signals takes a `refId`; ovok asks Signals which patient a Signals id is.