Patient Self-Registration

Create your account using this form without manual intervention from staff members. 

1. First Name: Enter your given name.
2. Last Name: Enter your last name.
3. DOB: Enter your birth date in the format MM/DD/YY (two-digit month, two-digit day, two-digit year).
4. Phone Number: Enter your cell phone number.
5. Email Address: Provide a valid and unique email address.
6. Password: Create a strong password.
7. Confirm Password: Re-enter your password to confirm.
8. Two-Factor Authentication: Enable this added security step for an extra layer of verification. A confirmation link will be sent to your email.

Steps for Patient Portal Registration:

1. Use the link shared by your clinic to access the Login Screen. Select the First Time Users - Click Here Option.
2. A Pop-up note will appear confirming that this step is meant for new patients. Select 'Yes, Register as a New User' to continue.
3. Fill out the Create Account Form with your first name, last name, date of birth, email address, and phone number.
4. On clicking/tapping Sign Up, you will see a confirmation that your patient portal account has been created. Check your inbox for a confirmation email.
5. Click/Tap the Activate Account Link and follow the instructions to finish the Patient Registration.
6. Fill out the Patient Demographics form and click/tap [[lbl:Save]]  for the next tab.

Fill out the Primary, Secondary, and Tertiary Insurance details and click/tap on [[lbl:Save]] to complete the registration.