NEW PATIENT PORTAL ACCOUNT SIGNUP
This form is for setting up a patient portal account. This feature is not fully developed yet. If you have a code to try Beta enter it into the field below.
ENTER THE CODE PROVIDED BY N-OD Toolbox™
ALL FIELDS ARE REQUIRED
FIRST NAME
LAST NAME
CLINIC NAME
CHOOSE WHICH CLINIC YOU ARE CONNECTING TO
Vision Clinics of D&L
EYE See Clinic
EMAIL (this is also your USERNAME)
CONFIRM EMAIL
PASSWORD (minimum 8 characters, at least one Uppercase, one Lowercase, one Number, & one Special Char: !, @, #, $, or %)
CONFIRM PASSWORD
If you see this, leave this field blank!
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