Did you know you can use the OutSmart Patient Portal to get access to your medical data?
The OutSmart Patient Portal gives you secure access to your appointment history, treatment plans, handouts and intake forms.
Technical difficulties? Contact OutSmart at 1-888-507-0826.
Medical Questions? Contact your health care practitioner, their contact information is provided in your e-mail confirmation.
Fields marked with a star (*) are required - only if you're booking for a new person.
|First Name *:
|Last Name *:
|Date of Birth *:
|Mobile Phone Number:
|Home Phone Number:
|Work Phone Number:
OutSmart requires the use of the Google Chrome browser. If you are not using Google Chrome, we strongly recomment you log out and log back in through the Chrome Browser. If you do not have Chrome, you can download it here: Download Chrome
If you are using Chrome and this message is still coming up, please contact us to let us know, and click OK to continue.
Do you require immediate assistance with OutSmart? You can reach us at:
Monday to Friday, from 8:00am to 8:00pm Eastern Standard Time.
Your Sharing PIN allows other practitioners using OutSmart to share their charts with you. Please keep this PIN private and only give it to other practitioners that you know.
This PIN will not allow anyone to access your account or your information. It simply allows them to identify you in the OutSmart Community, and safely share items with you.
You can provide your Sharing PIN to any practitioner that wants to share their charts with you.
Select a patient whose information is being requested through this form. You can then also further authorize other patients to fill up this form on their behalf.
Do you want the patient to fill out this form on a recurring basis? If so, please indicate details below:
*You can still manually repeat this form again from the Patient Submissions page.
Provide patient with repeat instructions:
Assign patients who are authorized to fill out this form. You may only assign people who are in your patient list. If the person you want to authorize is not in this list, you must first add them as a patient, and then return here to send the form. This section will only add assignments, not remove them - so patients authorizations cannot be revoked from here.
*Note: Smart Form codes are currently sent by e-mail. Assigned patients who do not have an e-mail on file will not receive any reminders or notifications of this form. The assigned patient will also not be able to fill the form without first creating a patient portal account. See here for instructions on how your patients can create a patient portal account.
Can be held in which room:
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Reminders are currently not compatible with recurring events. In order to set reminders for an event, you must first save the event, and then edit the event to add reminders.
You are about to cancel your appointment with at with the following reason:
Are you sure you want to continue?
You will receive an e-mail shortly confirming your cancellation.
No further action is required.
Please contact your clinic if you need to reschedule this appointment.
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