*Required fields are marked with an asterisk.

 

Tips on Using the Portal and Frequently Asked Questions

It is our policy to enter the patient's formal name as it appears on the most recent insurance card. When we ask for updated information, it should reflect the patient's formal name. Please do not correct with a nickname. We can add nicknames or preferred names to our record upon arrival.

Please make any entries, responses or answers in proper English avoiding short text messaging as much as possible.

Respond to as many fields that apply to a patient's condition. You do not need to answer a question if the response does not apply. An asterisk "*" at the beginning of prompt indicates a field that requires a response. If you get to the end of a form and it will not submit, check above in the form for an incomplete or empty required field.

When completing an eForm, please avoid use of the back arrow in your browser. Unfortunately, the back arrow will take you out of the form and you will need to start over.

When completing eForms that require electronic signature, look in the upper right hand corner or scroll to the bottom right on the page to find the sign button.