New Portal Login Request


Please submit the requested information below.  Also, please print the Patient Portal Request Form.  Once printed, please complete the form and return it to anyone of our three offices located in Oakland, McHenry or Friendsville.  When presenting your completed form at one of our offices, you’ll need your driver's license for verification purposes.
Once you have submitted your form it will take several business days before you will receive an email with login information.
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