Patient Forms & Links

NSIM Patient Forms

Before your appointment with us, quickly and conveniently access patient forms from our practice.

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.

MDVIP Patient Visit Forms

Patient Portal Log-in

Anytime, Anywhere. Managing your healthcare has never been so easy. Our Online Patient Portal facilitates better communication with our practice by providing established patients convenient and secure access 24 x 7.

Log-In Now

Using our secure portal you will be able to:

  • Manage personal and insurance information
  • Send messages to our clinical staff
  • Update Annual Physical Forms online
  • Review lab results
  • Request a prescription refill
  • Pay your bill

Although this tool is designed to be a convenient resource for our patients, it should not take the place of any important communications about your care. We continue to encourage you to call our office as necessary.

How to Sign Up

Sign up for access to request appointments, request prescription refills, update personal and insurance information, and pay your bill. If you have not already been given a username and password for portal access, please contact our office by phone.

Contact Us

Having difficulty logging in? Have a comment or question? Call us to let us know. Click here for Patient Portal Instructions.

COVID-19 Vaccine


We are sorry to inform you that, although we had originally planned to partner with Centennial Pharmacy Services to administer the COVID 19 vaccine shots in our office, we will be unable to
do so.

We realize that this is disappointing to many of you, as we were hoping to make it easy for our patients to obtain the vaccine. However, the Philadelphia Health Department has decided to not distribute COVID Vaccine through physician offices but to focus instead on retail pharmacies, large mega-sites, collaborative arrangements with community groups, places of worship and large hospital systems.

We recommend that you go to the Pennsylvania Department of Health and the Philadelphia Health department websites as well as those neighborhood pharmacies to find a vaccination location near you to schedule your shot. See the links below. If you are physically unable to leave your home, call our office and we can help you arrange to have a nurse come to your home to administer the vaccine.

https://www.health.pa.gov/topics/disease/coronavirus/Vaccine/Pages/Vaccine.aspx

https://covid-vaccine-interest.phila.gov/?lang=en-US

Please be sure to let us know when you’ve been fully vaccinated and we will update your health record.

WE URGE ALL OF OUR PATIENTS TO GET THE VACCINE. If you have any concerns about the safety, effectiveness, rapidity of development or other issues regarding the COVID vaccines, please contact your primary care provider at NSIM.

Please be sure to let us know when you’ve been fully vaccinated and we will update your health record. Once you have been vaccinated, please follow the CDC guidelines to fully protect yourself and others. https://ww.cdc.gov/coronavirus/2019-ncov/vaccines.fully-vaccinated.html

Please be patient. No one will be truly safe until everyone in our country who desires the vaccine has received it.  Please continue to wear your mask when outside of your home, maintain social distance, wash your hands, and follow other guidelines from the health department and CDC. Once you receive the vaccine, you will need to strictly maintain these precautions at all times until our public health officials tell us otherwise.

Wishing you good health,

The NSIM and MDVIP physicians, Nurse practitioners, and Staff

Call us (215) 440-8681  | View COVID-19 Vaccine Registration Info