ONLINE ASSISTANCE FORM

Having trouble registering for the patient portal?  Need medical records?  Not a patient but need to speak with one of our staff members?  We’re here for all of you!  Fill it out, and expect a call back from one of our staff members.  If you are having trouble registering for the patient portal, read below prior to filling out the form.  If you’re using it for anything else, please proceed directly to the form below.

IF YOU ARE A PATIENT AND HAVE NOT GAINED ACCESS TO OUR PATIENT PORTAL, PLEASE READ BELOW PRIOR TO FILLING OUT THE FORM:
Do not use this form for medical questions.  Those questions must be done via the patient portal in order to comply with patient confidentiality regulations.

The patient portal requires three things to be accurate in order to register:
1. NAME (if you have a hyphenated name, it may have a space instead, or it may not have the second part.  If it’s not identical to our system, it won’t work)
2. EMAIL ADDRESS (If you do not have an email account, go to www.gmail.com and sign up for one for free)
3. DATE OF BIRTH

When you first start to register, it asks for your name and email address.  It will then send you an email with a link to then confirm your name and date of birth.  Check your SPAM box if you don’t receive the email.  Here is a link to the patient portal registration: https://patientportal.advancedmd.com/126347/account/register.

IF YOU ARE HAVING TROUBLE REGISTERING FOR OUR PATIENT PORTAL, IT IS POSSIBLE THAT YOUR INFORMATION IS INCOMPLETE OR IS NOT ENTERED INTO OUR SYSTEM THE SAME WAY YOU ENTERED IT.  After you fill out the form, we will confirm your name, email address, and phone number with our system.  You will be contacted by our staff to confirm changes and assist you further, if needed.