Patient Forms & Links
Ninth Street Internal Medicine is part of an Accountable Care Organization (ACO). We’ve teamed up with other doctors, hospitals, and health care providers to make sure you get the best care. Learn more about our Medicare Shared Savings Program.
NSIM and MDVIP 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.
- Preparing for your Appointment
- Medicare Wellness Questionnaire
- Medicare Notice of Primary Care First
- Wellness Questionnaire
- COVID-19 Pre-visit Screening
- New Patient Evaluation and Wellness Questionnaire
- New Patient Evaluation and Medicare Annual Wellness Questionnaire
- HIPAA and Other Authorization Forms
- Upload Your ID and Insurance Cards
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.
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.
Having difficulty logging in? Have a comment or question? Call us to let us know. Click here for Patient Portal Instructions.