Patient Forms

PATIENT PORTAL

Welcome to the Patient Portal, a convenient online option for new patient forms, appointments, and statement summary. You can access this once you have made your first appointment with our practice.

If you already have setup the login for your portal, you can access it here.

The Online Patient Forms provide us important information such as medical history, dental history, dental insurance information and an opportunity to communicate any special needs for your child well before your scheduled visit.

1. The Patient Demographics form may be completed only one time if the information is the same for all children.
2. The Child Health History form must be completed for each child.

First time portal setup and login

1. To setup the portal, we will need an email address, birthdate and zip code for the person that calls our office to make the new patient appointment. These three items are used to verify your identity during setup and login.
2. Our office will send the portal setup email, and in the body of the email, click the blue link “Log Me In”. The link expires in 24 hours, and you must setup your portal immediately upon receiving the email. If the link has expired, call us at 703-849-1300 to receive a new link.
3. You will be taken to a screen ‘Please Verify Your Identity’ that asks you to enter your birthdate in mm/dd/yyyy format and zip code.
4. After creating a password, click “submit” and the login screen will appear. Enter the username and password and click the Log In button, and the portal will appear.

Future Logins: Once you have completed the initial steps for setting up the patient portal, you can access it at any time by going to banajidds.curveconnex.com. Use the same username and password previously created.

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