Patient Portal

We utilize our Patient Portal for you to update your information and medical history prior to your visit. Completing this before your appointment will ensure a smooth and easy check-in process in our office.

If you are registering for the first time, your First & Last Name, Date of Birth, and ZIP Code must match exactly how it appears in our practice system. If you do not know your Security Code, please give our office a call so we can further assist you. All information provided is confidential, secure, and HIPAA compliant. If you are already registered with and need to connect to our practice, our Practice ID is POQSKQ.




If you need help with troubleshooting your registration, you may email us here.

Other Forms & Information

Below you will find other important forms. It is the responsibility of the patient to verify whether we are In-Network with your Insurance Plan. You may call your Insurance Provider and give them our Tax ID #58-1846036 to verify your In-Network Benefits. We are credentialed through Piedmont Hospital and file to all plans that Piedmont Hospital accepts.

Consent To Minor
All minor's under the age of 18 must be accompanied by a parent or legal guardian. Existing Patients may be seen without a parent or legal guardian present with proper consent.Download
PHI Consent
Please complete the Consent for Use & Sharing of Patient Health Information (PHI) form and bring in with you for your appointment.Download
Request Medical Forms
To request a copy of your records, please complete the following form. You may upload the completed request via the Patient Portal, or email/fax it to the office.Download

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