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Patient Account Registration
Patient Account Registration

All fields are required.  Registration for the Patient Portal is free and the best way to stay in contact with Bayside Gynecology.

Please Note:  It may take several minutes to receive your registration confirmation email.  Please be patient and also be sure to check your SPAM folder.

Patient Portal Registration

*Note: Membership to this website is Verified. Once your account information has been submitted, you will receive an email containing a link that you can use to verify your account. All fields marked with a red asterisk are required. - (Note: - Registration may take several seconds. Once you click the Register button please wait until the system responds.)

Enter a first name
Enter a Last Name
Enter a username. It must be at least five characters long alphanumeric value
Enter a valid Email address
Enter your password
Re-Enter the password to confirm you typed it correctly
Enter a telephone number
Enter the street part of the address (eg. 123 Main Street)
Enter the city part of the address
Enter the region (state, province or county) part of the address
Enter the Postal/Zip Code part of the address
Enter the security code