Forms

Our online forms are HIPAA-compliant and secure for new, existing, and transferring patients. If you prefer paper, each form can also be printed. We encourage patients to complete paperwork in advance for a smooth visit.

 

  • Please complete the registration and medical history before you arrive. Allow 20 minutes.

    Registration and membership signup. Learn about our membership program here.

    Our privacy practices has detailed information about your rights and our responsibilities.

    Don’t be blindsided by a late fee. Our financial policy is right here.

  • Our membership program began February 2022. If you plan to continue as our patient but haven’t joined, please return your membership election form a.s.a.p. Any questions not answered on the Membership page? Please call or email.

    Before your yearly visit, please complete an annual exam update.

  • Transferring your care to Advanced Gynecology?
    Complete this form, and we’ll contact your prior practice on your behalf. Or print, sign, and drop it off with your previous physician.

    Transferring your care from us to elsewhere?
    Complete this version, and we’ll send your records to your new physician.

 
 

Billing Portal

We take payments by mail, phone, Zelle, or secure portal. If you have a card on file for the membership fee, you can also email or leave a voicemail with your request to use that card for your bill. (Do not put the card number in your message.)

 

  • Zelle to payments@advancedgyne.com Zelle is a free, app-based, FDIC-insured, bank-to-bank service. Put your name in the memo field.

  • The NueMD billing portal can be confusing! When you first sign up, click “Don’t want to use SSN” to ID yourself instead via your cell or city/zip. Other tips:

    • The payment button accepts any credit card, not just Paypal.

    • If a Paypal window opens when you prefer another method, click “Pay with Debit or Credit Card.” Paypal’s guest checkout will let you enter that other card.

    • Want paperless statements? Here’s how to sign up.

  • Making a partial payment? Late fees will still accrue unless we have a scheduled plan and a card on file. Call to arrange. +1 847-568-1488

 
 

Patient Portal

 

We use an electronic health record that lets you to take charge of your health history. At your visit, you'll be given a password for Patient Fusion. You'll have secure access to your medical records, 24 hours a day:

  • View diagnoses, immunizations and prescriptions

  • Look up test results

  • Schedule or view appointments

The patient portal is not for emergencies! If you need urgent care, please call 911. 

 
 
 

Resources

 

It's easy to be overwhelmed by health information on the internet. Here are trusted resources to help focus your questions. The internet can't replace a discussion with your doctor. Our goal is to give you accurate  resources to help direct your questions.