Naples Plastic Surgery
Online Patient Resources
FORMS
We are now using electronic medical records and we will need you to enter your demographics and medical history online prior to your appointment. The simple steps to enter your information are as follows:
*We would appreciate if you sent us a message through the patient portal once you complete your form to let us know it’s complete. If you have any questions regarding how to complete it, please let us know!*
PLEASE PRINT THESE INSTRUCTIONS FOR REFERENCE
Please rest assured that all information provided is kept confidential, secure, and HIPAA compliant. Please call the office at 239-566-2611 if you have any questions.
STEP 1: Click on this link or the button at the top of this page to access our secure patient portal. Our practice ID is: AMHGXD
STEP 2: From the home page, under “Don’t have an Account?” click the “Create an account” button to the left of the login. NOTE: Even if you have a preexisting portal account (that is not specifically with mypatientvisit.com), you will still need to create a new account.
STEP 3: Fill in all Sign-In information in the provided fields and create a unique password for the account.
NOTE: The First/Last name and email address you enter must match the information on file with our practice
STEP 4: Read the full “Terms & Conditions” and click the acceptance checkbox. Click “Create Account”
STEP 5: A screen displaying “A confirmation email has been sent to the email address” will appear (for initial registration, email confirmation is not required); Click “Continue.”
STEP 6: The “Connect to a Practice” page will appear.
STEP 7: Fill in the provided information fields on the page, such as Practice ID & Date of Birth.
NOTE: The system may autofill this information when clicked. If so, disregard this step
STEP 8: Click “Connect.” If all information is valid and matches your record in our system, you will now see a “Safe Health Code” page. Select a preferred method for receiving this code (email recommended).
NOTE: Do NOT close the MyPatientVisit page or browser when retrieving Safe Health Code, as doing so will cancel out the registration process
STEP 9: Retrieve your Safe Health Code from your email and input this code in the provided field. Click “Connect.”
STEP 10: Patient Dashboard will appear. From here, you can access tools and information via your secure patient portal. Complete the check-in process by clicking the “Preregistration” button and review your demographics information by following the navigation bar at the bottom of the screen.
Our online forms and links cover information relating to new patients, insurance, consent and financing. Our “Cosmetic New Patient Form” is designed to elicit information from you regarding your personal cosmetic enhancement desires, along with necessary details about your overall health and medical history. The “Insurance New Patient Form” allows you to provide us with the information needed to bill your insurance company(ies) for applicable procedures covered by your policy(ies).
The questions on both forms regarding your general medical history are necessitated by the need to ensure that treatments provided by Naples Plastic Surgery will not be negatively impacted by previous medical conditions or other elements of your overall health. Knowledge about your current medications is also of utmost importance to insure that no adverse reactions occur due to interactions between these medications and ones that may be needed as part of your treatment.
If you are uncomfortable relating particular information regarding your medical and health history on these forms, you should notify a staff member. There is also an entry at the end of the “Cosmetic New Patient Form” that allows you to notify your surgeon that there may be issues that you did not wish to include on the form.
The “Consent Form” is legally required to allow Naples Plastic Surgery access your protected health information for the purposes of diagnosing and providing you appropriate treatment. The form also allows disclosure of protected health information for the purposes of obtaining payment for any treatments performed by Naples Plastic Surgery. This form further advises potential patients that they have the right to review the office’s “Notice of Privacy Practices prior to signing the document. You can review Naples Plastic Surgery’s “Notice of Privacy Practices” here.*
The “Care Credit Financing” link Takes you to the “CareCredit Patient Payment Plans” home page, which describes options for financing your plastic surgery treatment, and provides a portal in which to apply for financing. Naples Plastic Surgery works with CareCredit to provide patients with several reasonably priced alternatives for financing your cosmetic enhancement. CareCredit has been in the medical financing business for more than 30 years, and offers financing for most surgical and non-surgical procedures offered by Dr. Gardner.
239-566-2611
