"*" indicates required fields

Patient Name*
Date of Birth*
Ocracoke Health Center requests all electronic communication with our office be through our Patient Portal website. The patient portal provides a secure method for communicating with our office. It complies with all HIPAA privacy laws and assures the confidentiality of your message.

In addition we will start placing documents (lab results and visit summaries) on the portal for you to access.

PATIENT PORTAL WEBSITE: http://ohc.myphysicianoffice.com

When we create your account, you will be assigned a unique username (typically your e-mail address) and an initial password. In the event that your email address is a shared address and already being used, a number will be assigned for the username. The username can be changed after you have logged into the portal for the first time. This information will be printed and a hard copy given to you. When you logon for the first time you will need to enter that username and password and confirm your date of birth. The portal will then require you to change the password. Please remember your new password as you will use it for future logins.

EMERGENCY PROBLEMS: The portal should never be used for emergency problems. In the event of an emergency, call 911.

URGENT PROBLEMS: The portal should never be used for urgent problems. In these cases, the patient should call the office at 252 928-1511.

BE CONCISE: Communication through the portal should be concise. If your problem is too complex to discuss via a simple message, you should make an appointment by calling: 252 928-1511.

MEDICAL RECORD: Any message you send to our office through the patient portal may become part of your permanent medical record.

RIGHT TO OPT OUT: You have the right to opt out of using the portal account at any time. The option to opt out of an existing portal account can be found under my profile tab on the portal itself.

PATIENT ACKNOWLEDGEMENT AND AGREEMENT

I acknowledge that I have read and fully understand this consent form. Any questions I may have had were answered.
Date*
This field is for validation purposes and should be left unchanged.