Welcome to the HIPAA-Secure Online Forms page for Stuart Akerman, MD (DHAT)

Please take a few moments to complete the following form(s). By doing so, you will speed up your office visit and/or procedure, and allow us to better serve you. For your protection and security; information you enter will be encrypted and safely sent directly to our office once you complete all sections. Navigating away from this form system or allowing it to “Time Out” before clicking "Submit" will cause the dismissal of any entered data. After successful submission you will be redirected to a Confirmation/Thank you page.

It should take about 10 minutes or less to fill out a New Patient Packet, comprised of forms and notices requiring signatures. 

It should take about 5 minutes to fill out an Open Access Colonoscopy Form. 

It should take 1 minute to fill out an Insurance Verification form

By entering your full name where requested, you will be able to submit your signature(s) electronically.