In order to satisfy government requirements and those of our electronic medical record system registration MUST be done after receiving the tentative appointment. Thank you for your patience and understanding!
Complete BOTH step 1 AND step 2 of the new patient forms below.
Thank you once again for helping our office provide you with efficient, quality care through these steps.
New Patient Demographics
(this is necessary information for your appointment
Our office staff will be contacting you within 48 hours after Step One
is completed to provide you login information for Step Two
Once you HAVE received your unique id and password from our office staff, please proceed to the link below (Online New Patient Medical History).
New Patient Medical History
- (login required - this will link to your patient portal for required medical information
**Please Note: Some areas within your portal, such as certain demographics, you CAN NOT modify or type (usually in gray boxes). If these need changed please notify our office to do so. Also, the best experience is through Firefox browser if that is available on your computer**
You are done! Be sure to mark your appointment date and time on the calendar. Thank you very much for helping us make your visit with us an efficient and enjoyable experience.
***Our staff is here during regular business hours to assist you if needed. You may press 3 to speak with (or leave a message with) our Pre-registration team. If leaving a message please allow 48 business hours for a reply.***
Physician Referral Form (for physician offices)
Treatment of a Minor Permission
Nondiscrimination and Accessibility Requirements & Statement (in multiple languages)