Patient Registration (Getting Started)
Welcome to CPRCC. If you're a new patient, please continue to the Patient Registration Form, where you will input necessary information about yourself. This information will include the following:
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Patient Information
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Emergency Contacts
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Physician Information
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Authorization to Access Electronic Prescription Information
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Allergies
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Medications
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Current Symptoms
Upon completion of the registration process, our automated system will collect your insurance information. Additionally, forms for medical information release and our HIPAA-compliant policies will be available for your review and electronic signature. This information is securely transmitted using encrypted services to ensure your privacy.
You may also download and manually complete the Patient Registration Packet via PDF. This packet can be emailed or brought to the office during your appointment. Please complete the appropriate update form if you have any updates to your information, such as a name change or insurance coverage. Our staff may also request an updated copy of your information. Updating your information is similar to completing the online Patient Information Form. If you have any questions, don't hesitate to contact the office, our staff will be more than happy to assist you.
If you have not previously completed the form either online or in person, a member of the front desk team or a nurse will provide you with a paper copy when you arrive at the office. To begin completing the forms electronically, click the Get Started (Registration Form) button below.
Welcome to CPRCC. If you're a new patient, please continue to the Patient Registration Form, where you will input necessary information about yourself. This information will include the following:
-
Patient Information
-
Emergency Contacts
-
Physician Information
-
Authorization to Access Electronic Prescription Information
-
Allergies
-
Medications
-
Current Symptoms
Upon completion of the registration process, our automated system will collect your insurance information. Additionally, forms for medical information release and our HIPAA-compliant policies will be available for your review and electronic signature. This information is securely transmitted using encrypted services to ensure your privacy.
You may also download and manually complete the Patient Registration Packet via PDF. This packet can be emailed or brought to the office during your appointment. Please complete the appropriate update form if you have any updates to your information, such as a name change or insurance coverage. Our staff may also request an updated copy of your data. Updating your information is similar to completing the online Patient Information Form. If you have any questions, please get in touch with the office; our staff will gladly assist you.
To begin, click the Get Started button below. When complete, click the Submit button on the form and then complete the Insurance Form followed by the Privacy Form and Other Forms.