Patient Portal & BillPay Enrollment

Patient Portal Enrollment

When you access our patient portal, you are able to review a complete health information summary for each child in your care, including:

Upcoming appointments
Date of most recent physical
Historical visits
A summary of labs and medical tests
A problem list, allergy list and medications list
A complete and printable immunization record

You will also be able to communicate with our office by sending and receiving secure messages via our online patient portal. To sign up for access, complete the fields at right and return the form to us via the submit button to complete enrollment. You will then receive an email from us with your login and temporary password.

Please note that your sign-up form may take up to 24-48 hours to process. If you are in need of urgent assistance, please call the office at 214-368-3659.

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Portal Sign-up

Your Name (First and Last Name):

Phone Number:

Email:

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Today's Date:

Doctor:

Patient(s) name(s) & date-of-birth(s):

Electronic Signature (Please type your first and last name)

Blue Pay

Please sign below if you would like to view balances and utilize our online bill-pay functionality through BluePay.

Electronic Signature (Please type your first and last name)

Date

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Clinical Pediatric Associates

Patient Portal & BillPay Enrollment

Patient Portal Enrollment

Please note that your sign-up form may take up to 24-48 hours to process. If you are in need of urgent assistance, please call the office at 214-368-3659.

Portal Sign-up

Blue Pay