HTFM Patient Portal - Publicforms

Available Forms

*1 New Patients: Consent for Treatment & Payment & Acknowledgements *2 New Patients: Cancellation & No Show Agreement *3 New Patients: Text Messaging *4 New Patients: Patient Financial Responsibility *5 New Patients: Updox Patient Portal *6 New Patients: Telehealth (VideoChat)Consent form *7 New Patients: Alternate Phone/Person *8 New Patients: Address and Insurance form *9 New Patients: Medical Records Request To Us 10) New Patients: Please Read! Thank you! 24) Patients Rights & Responsibilities 27) Telehealth (VideoChat) Consent form 31) Address and Insurance Update form 34) Consent for Payment Plan 35) Medical Records Request From Care Management Request for Medicare CCM Staff Log Patient Satisfaction Survey Prescription Refill Request

*5 New Patients: Updox Patient Portal

Updox Patient Portal

Welcome to Updox with Home Towne Family Medicine. Since you provided us your email address you will now be able to send secure messages to the staff, receive appointment reminders, download copies of statements, tests and so much more!.

Your account is set up to recieve messages and documents from us. You will be notified by email each time we post a message for you in Updox. Simply click on the link within the email and follow the directions. Dont forget to save http://HTFM.myupdox.com and your username and password.

Is my information secure and confidential? Yes, Updox keeps your information as secure and confidential as is possible on the Internet. It?s your health record and information is not shared without your consent.

Statements

Statements are mailed out to you at the end of each month. If you opt to join the ?Updox Secure Patient Portal? you will also receive an electronic copy of your statement, with a link to pay on line!

Reminders

You may have already experienced our new process for reminders. We want to make it easy for everyone to confirm or cancel appointments with ease.

Here you can set up your preferences. *

No preference

Text message reminders only- 48 hours before the appointment

Email reminders only- 1 week prior to the appointment.

Home phone reminders only- 24 hours before the appointment

Mobile phone reminders only- 24 hours before the appointment

No reminders

Please select your preferences below, and notify us immediately if anything changes.

Based on your selection above please provide the information we will need to send your reminder. ie phone number, email or both *

Note: if you choose no preference you will receive a text and phone call.

Patient Name *

Date of Birth *

Todays Date *

* Required field