Online Medical Records Submission
Logon to the following web site in your web browser
For your initial login use “new” as your username and password. (You will set a new username and password on the next screen. Please use this for any subsequent logins to this system.)
General Tab
Please enter all information on this screen and select “Save” at the bottom
Several Tabs will appear at the top of the page after you select “Save”
Medical History Tab
You do not need to enter any information here. This info is asked for in another section
Immunization Tab
Please enter any immunization information available
- Click “Edit” to activate a row
- Enter the information
- Click “Save” to save the information to our database
- Repeat these steps for all additional immunications
Insurance Tab
Please enter all insurance information in this area
- You must enter information for:
- Medical insurance (primary and secondary)
- Dental Insurance
- Vision Insurance
- Prescription Drug Insurance (if different from Medical Insurance)
- If you do not have any insurance or you do not have a particular type of insurance, please enter “None” as the insurance company for that type
- Click “Edit” to activate a row
- Select an “Insurance Type”
- Select a “Company”
- If your insurance company is not listed in the drop down menu, Select “Cancel” to the left
- Then select “Add a New Insurance Company” at the bottom
- When the window opens, enter the name of your insurance company
and select “Save Company”
- The new company will be saved and you will be taken to the primary window to enter the rest of your information
- Be sure to select an “Ins. Type”
- Enter the remainder of the requested information
- Click “Save” to the left after you are finished enter information for that company
- Repeat these steps for all Insurance Types+
Contacts Tab
Please enter emergency contacts in this area.
- Select “Edit” to activate a row
- Please fill out ALL information for this person
- You may enter multiple contacts if you would like
There are currently two forms that must be completed
- Health History Questionnaire (allow plenty of time to complete this form)
- ADHD Information Form
- Medical Examination & Authorization Waiver
- MRI Questionnaire
For Each Form
- Select the Form from the drop down list
- Click on “New” to the right to begin the form
- It may take a few seconds to load the entire form
- Answer all questions on the form
- Note the questions marked with an * are required
- Be sure to explain any Yes answers in the boxes provided
- Click “Save” at the bottom of the form


