If you are a new patient, uploading your Driver’s License/Government Issued Photo ID and your Insurance Card will ensure the check-in process for your first appointment will be as quick as possible.
If you do not have insurance, click Not Applicable.
INSTRUCTIONS
- With your smartphone, take a picture of the front and back of your Photo ID and Insurance Card prior to starting this form.
- To upload your images, click the “Choose File” button below and locate the image on your phone.
- To ensure your images upload properly, take the photos BEFORE you start the form. Do not use the “Take Photo” feature within the form.
Contact our office between 8 am and 5 pm M-F if you have any questions. NOTE: Your files are fully encrypted with HIPAA-compliant software to ensure your security and privacy.
