Patient Intake Online Forms

Detailed Instructions:

1. Click on the blue icon  for the form you want to submit in the list of Online Patient Forms section below.
2. Type in your “Full Name” and “Your Email” address.
3. Click on “Continue” button. .
4. Now, check your email for a new email from Dr. Fujimoto with subject line “Please fill out this form (x)” Note:  If you didn’t receive an email check your “Spam” or “Junk” folder for the email.
5. The email will contain a unique password in Red.
6. Copy and paste or type in your password and click “Open Form“  .
7. Follow the instructions by answering the questions and clicking “Next” .  You can go back by clicking “<- Previous” if you make a mistake on a previous question.
8. You may have to sign a consent form before continuing. 
9. Using your mouse, hold down the mouse button and drag it along to sign your signature or if you have a touch screen, use your finger.
10. If you need to start your signature over, click on (Clear) at the bottom right of the signature box.
11. You can also click on  “Type It“ under “Your Signature” to use your keyboard to type in your signature.
12. When you are finished signing or typing in your signature click “Confirm Signature” .
13. Once you login and start a form you can leave and continue where you left off by clicking on “Open Form” button in your initial email you received from Dr. Fujimoto.
14. Once you are done the form, click “Submit Form” .

We may require you to fill out another form prior to confirming your appointment so if you don’t hear from us, check your email for another online form request.