Completing the New Patient Questionairre

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Completing the New Patient Questionairre

Instructions for completing the New Patient Questionairre

First, make sure you have received a login and password from our office.

If you are trying to get pregnant and have a male partner, your partner must also obtain a login ID and password and complete his questionairre also.

When you first login you will see this disclaimer page:

Disclaimer Page

After clicking, "I agree", you will be taken to the first of four Demographic Pages

Screenshot of demographic page

You can review the information on the demographics pages. If you like, you may skip these pages.
Add or make any necessary changes to the information on the first four pages:

a. Your demographic information
b. Information about your spouse / partner (if any)
c. Your primary insurance coverage (if none, click skip
d. Your secondary insurance coverage (if none, click skip)

NOTE: Changes to any of these four pages WILL NOT show on Patient Portal for 2-3 business days.

When you have completed (or skipped) these first four pages, you will next be taken to the patient portal "Home Page"

Screenshot of main portal page

You MUST now complete the New Patient Questionnaire. In the left menu bar, Click on Questionnaire (see red arrow above)

Next click the link "Patient Evaluation"

Patient Evaluation Link

This will bring you to the main menu page for the New Patient Questionairre (see below).
You will notice that your medical history has been divided into 9 sections or "steps".

Screenshot of the main page of the new patient questionairre

Clicking on each step will bring up a page for you to complete.

Screenshot of Female Information Page

This is a screenshot of the first section.

Section Completed

After you have finished a section, it will be marked "completed".

You may stop and start as many times as you like. If you haven’t finished but want to come back to complete the questionnaire later, please be sure to click "Save and Close". You can change you answers if needed up until the time you have your initial consultation. Clicking on "Summary" will allow you to review the entire questionnaire on one screen. You can also print out your questionnaire if desired.

Last Updated ( Wednesday, 08 June 2011 )