Online Patient Information Form

You have the option of completing the necessary medical questionnaire online by going to the secured web site at

https://doxweb.doxemr.com/ca_1204

 

Utilizing this option will cut down on your wait time in the office

Your login is the 1st initial of your first name, your last name and your date of birth using two digits for the month, two digits for the day and four digits for the year.

Your password is your last name and your 10 digit phone number that’s on file in our office

All in lower case NO commas, NO dashes, and NO spaces