Online Patient Registration

Patient Registration Form

Doctor: The old form that we have used in the past is not HIPAA compliant and we no longer offer it to our doctors because of that reason. You are certainly welcome to use it however we do not recommend it. We have many alternative options for you to consider.

1. PDF printable version of your referral form.(free)

2. Web Connect: This product is a secure convenient way to perform tasks such as appointment scheduling, email reminders bill payment, patient payments, online referral collaboration and electronic referrals. You may view this product by clicking this link http://www.webconnectcollab.com
(use the password demo and user demo to access)

This is currently offered for free but will have a fee at a later date. I can also have Jay give you a demonstration if this sounds interesting.

3. A Hipaa compliant secure Truform page which can be submitted online. (Call for proposal)