Our secure upload works with your smart phone, tablet or computer and saves time by not needing to copy your Health Insurance ID Card at your first appointment.
If you have already submitted pictures of your Health Insurance ID Card with our Online Intake, you do not need to complete this form.
If you would prefer to not upload through our website, please bring your Health Insurance ID Card for your first appointment.
For your security and privacy, the information you submit will be sent and stored with HIPAA-compliant encryption to protect your sensitive information.
Depending on your browser, you should see a padlock at the top of the address bar and a live Trusted Site security seal on the lower right of your screen.