If you are experiencing a medical emergency, please dial 9-1-1 by phone.

  • This form is to contact Patient Gateway support about a technical problem.
  • This form is NOT for medical care issues or to communicate with your physician's office.
  • For Billing related questions - please return to your Patient Gateway mailbox and
    respond to the original message OR access the Billing customer service telephone
    number by referring back to the statement you received, either by mail or electronically.
  • Required fields are marked with an asterisk (*).
  • First Name:*   Middle Initial:
    Last Name:*  
    Email Address:*  
    Patient Gateway 'Username' (if known):  
    Daytime Phone Number:* () -   Ext: 
    Best time to reach you:  
    Do you need Password help?*  Yes    No
    Home Address:
    *
    CityStateZip
    What is your technical problem?*  
         
    To talk directly with technical support, you may call 800-745-9683.

    The support team monitors email and telephone messages on business days — Monday to Friday, 8 a.m. to 5 p.m., EST — and will make every effort to contact you within 3 business days.

    Thank you for visiting Patient Gateway.