Patient Portal Assistance

Questions marked with a * are required
If you need assistance logging into your patient portal account or need to access your records from before June 1, 2017, please fill out this form. 
First Name
Last Name
Phone Number
Your Current Email Address
What do you need help with
IMPORTANT: We will not provide you answers to your medical questions here. This process is only to help you gain access to your patient portal account. There, you can communicate with your doctor and nurse, review results and see your medical records. 
If you can, please provide a date of service
I understand that this is a general contact form. I am voluntarily including any personal health information herein. This form is only applicable to NMC-owned locations and facilities.
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