Patient Portal - Sign Up

Please complete the form below. This information helps us create your account.

If the information you have provided matches the information in your medical record, you will be directed to a page where you can create your username and password. After doing so, your account is created and you will be able to set your notification preferences.

If the information you provided does not match with the information in your medical record, the Health Information Department will be notified and will review your request. You should expect a follow-up email or call within 7 days.

Patients 12 and over are considered independent users of online medical records by Illinois law and can be issued an account. Anyone 11 and under must have a parent or legal guardian responsible for their online medical record and will not be issued their own account.

For questions please call the Patient Support Line at (217) 326-4001.

Follow these steps to sign up for a Patient Portal account.

Enter your personal information.

Verify your contact information.

Choose a username and password.

If you have any questions, please contact us at (217) 326-4001.

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Follow these steps to sign up for a Patient Portal account.

Enter your personal information.

Verify your identity.

Choose a username and password.

If you have any questions, please contact us at (217) 326-4001.

Indicates a required field

Follow these steps to sign up for a Patient Portal account.

Enter your personal information.

Verify your identity.

Choose a username and password.

If you have any questions, please contact us at (217) 326-4001.

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First, we need to collect some information about the patient. If you have any questions, please contact us at (217) 326-4001.

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Now, we need to collect some information about you. After you submit the request, we will set up your appointment. If you have any questions, please contact us at (217) 326-4001.

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We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.

First name

Middle name

Last name

Date of birth

Legal Sex

Female Male Unknown

Last four digits of SSN

Medical record number

Home phone

Mobile phone

Work phone

Email address

Verify email address

By clicking submit below, I affirm that I am the patient. I understand that if I am not the patient and I access this medical record without the required proxy access, I may be in violation of federal and/or State law.

Sign Up

Name

Address

Other Information