Progressive Medical Associates PLLC

Available Forms

**NEW PATIENT (1) - REGISTRATION FORM **NEW PATIENT (2) - HEALTH QUESTIONNAIRE **NEW PATIENT (3) - HEALTH SCREENINGS **NEW PATIENT - MEDICARE (Age 65 + ) *ANNUAL WELLNESS (Age 65 + ) *ANNUAL WELLNESS (Under Age 65) CONTACT FORM FORGOT MY USERNAME MAKE A CO-PAYMENT ON YOUR ACCOUNT MAKE A PAYMENT ON YOUR ACCOUNT MAKE PAYMENT ARRANGEMENTS UPDATE DEMOGRAPHICS UPDATE EMAIL ADDRESS UPDATE INSURANCE INFORMATION VITALS & CO-PAY

FORGOT MY USERNAME

Your Username is usually given to you on your first visit to the office, along with your password. If you do not remember your Username, submit this form and we will send an email to the email address we have on file and provide you with your Username and a temporary password. After logging in the first time, you will need to change your password to one of your own (you can also change your Username if you wish by clicking on My Profile).

First and Last Name *

Email Address *

Enter the Email Address that you wish to use to receive notifications from us that you have documents in the portal.

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