Instructions for completing the New Patient Questionnaire
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 questionnaire also.
When you first login you will see this disclaimer page:
After clicking, “I agree”, you will be taken to the first of four Demographic Pages
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”
You MUST now complete the New Patient Questionnaire. In the top horizontal menu, click on “History”
Next click the link “History Form (Patient Evaluation)”
This will bring you to the main menu page for the New Patient Questionnaire (see below).
You will notice that your medical history has been divided into 9 sections or “steps”.
Clicking on each step will bring up a page for you to complete.
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.
