Patient Registration Forms

Step 1

Please complete the required steps before your Patient Experience Liaison telephone call.

• Activate your patient portal for access.
• Complete the Patient Intake Form located in the “Forms” section.
• Sign forms via EngagedMD using DocuSign and complete the modules (this is emailed to you).
• Upload any pertinent medical records, photo ID, and insurance card images to the portal by creating a new message.

Completion of these items may allow your Liaison to be able to get you scheduled quicker and decrease delays to testing and treatment once connected with your care team.

Step 2

Please complete the Release Form if you have relevant outside medical records and would like our clinic to request on your behalf. A request can be sent through your patient portal messages.