Registration Forms
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Pre-registration must be completed before your appointment. Note the following before you click the link:
Register via Username
- Click on link to “register by username”
- Create your own username and password (proceed without entering email)
- Enter 3 security questions and answers
- Enter the security code.
- Your name must match the name you provided the practice when you scheduled your appointment.
- Once logged in, click the pre-registration button to fill out your mandatory patient paperwork.
Please rest assured that all information provided is kept confidential, secure, and HIPAA-compliant. Please call the office at 219.500.5766 if you have any questions.