How It Works
Welcome to YourPractice’s online tool for submitting patient
information before your scheduled visit.
By submitting your information through this secure web site, you can
provide your medical information from the comfort of your own
Many patients prefer to submit their pre-visit information using this
secure site because of the:
Easy access to past medical records, and
Comfortable, confidential setting
Please read the following about using YourPractice’s online
patient information form:
Please provide as much of the information requested on the following
pages as you possibly can.
Some pieces of information are required.
YourPractice’s online form makes it easy for you to identify
the required information. If a piece of information is required, it
is marked with a red asterisk (*).
If you happen to miss entering a piece of required information, the
online form will remind you by highlighting the required fields in
yellow when you click on the “Next Page” button at the bottom of
each questionnaire page.
You can edit the information you entered before submitting it.
After you have completed the required information on each page, you
will be presented with a
Patient Information Summary. The Patient Information Summary makes
it easy for you to:
Review the entries
Change your entries,
Add more information,
Print a copy
of each Summary page for your own records.
when you are satisfied and you will see a screen thanking you for your
to fill in the form.
Thank you for using YourPractice’s online patient tools.