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Valid to March 31, 2022SLIDING FEE SCALE APPLICATION PERSONAL INFORMATION ___ LAST NAMEFIRST NAME___ DATE OF BIRTHSOCIAL SECURITY NUMBER___ ADDRESS CITY, STATE & ZIP___ HOME PHONE NUMBERCELL PHONE
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How to fill out your new patient portal
How to fill out your new patient portal
01
Visit the website of the healthcare provider where the patient portal is located.
02
Click on the link to register as a new patient.
03
Fill out the required personal information such as name, date of birth, address, and contact information.
04
Create a username and password for logging into the portal.
05
Agree to the terms and conditions of using the patient portal.
06
Verify your email address or phone number to activate your account.
07
Start using the patient portal to schedule appointments, view medical records, and communicate with healthcare providers.
Who needs your new patient portal?
01
Patients who want convenient access to their medical information.
02
Patients who want to communicate with healthcare providers electronically.
03
Patients who want to schedule appointments online.
04
Patients who want to view their test results and medical history.
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What is your new patient portal?
The new patient portal is an online platform that allows patients to access their health information, schedule appointments, communicate with healthcare providers, and manage their healthcare needs.
Who is required to file your new patient portal?
Patients are required to file their information in the new patient portal to ensure accurate health records and efficient communication with their healthcare providers.
How to fill out your new patient portal?
To fill out the new patient portal, patients need to log in using their credentials, navigate to the registration or profile section, and input the required personal and health information as prompted.
What is the purpose of your new patient portal?
The purpose of the new patient portal is to enhance patient engagement, streamline communication between patients and providers, and provide easy access to medical records and services.
What information must be reported on your new patient portal?
Patients must report personal information such as name, address, date of birth, insurance details, and health history, including current medications and allergies.
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