New User Registration for Established Patients

This form is for established patients only.Use the form below to create a new account.

Entered information must match the information provided to our office.
Due to HIPAA security requirements each patient/child must be registered individually and must have an unique functional email address.

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Coastal Radiology AssociatesTerms and Conditions of UsePatient PortalThese terms and conditions of use ("Terms of Use") govern all access to and use of the Coastal Radiology Associates ("Coastal" or "we") patient portal located at http://www.coastalradiology.com ("Portal"). Your access to and use of the Portal are subject to your agreement to these Terms of Use, and your accessing or using the Portal constitutes your acceptance of the Terms of Use as they appear at the time of your access or use. Coastal may modify these Terms of Use at any time, and such modifications shall be effective immediately when the modified Terms of Use are posted at the Portal. Your continued use of the Portal after any modifications will constitute your acceptance of the modified Terms of Use. You agree to review the Terms of Use periodically to be aware of such modifications.PurposeThe purpose of the Portal is to provide to you convenient access to the portions of your medical records we maintain in the Portal, including available prescriptions, appointments, and lab results. The Portal will only be accessible to active patients. If you cease being an active patient of Coastal, Coastal will have the right to disable your access to the Portal. Voluntary UseParticipation in the Portal is voluntary, and you are not required to use the Portal to receive care from Coastal.Medical EmergenciesIF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, YOU SHOULD NOT RELY ON THE PORTAL FOR ASSISTANCE, BUT YOU SHOULD INSTEAD CALL 911 AND SEEK APPROPRIATE EMERGENCY MEDICAL ASSISTANCE.Not Medical AdviceThe content of the Portal is for informational and educational purposes only. We do not provide medical advice through the Portal. The Portal is not a substitute for the advice, care and treatment of a physician or other health care provider. You are responsible for verifying the accuracy and completeness of all information you receive through the Portal.PrivacyPlease read our HIPAA Disclosure and Notice of Privacy Practices located at http://www.coastalradiology.com/documents/HIPAA_Disclosure.pdf (the "Disclosure") and http://www.coastalradiology.com/documents/Notice-of-Privacy-Practices-2013.pdf (the "Notice") to understand how we will treat any medical information (as that term is defined in the Notice of Privacy Practices) that you submit via the Portal. The Disclosure and Notice are incorporated into these Terms of Use. Information you communicate through the Portal may be incorporated and retained in Coastal's medical record for you and may be disseminated as part of an authorized release of a copy of that medical record.We do not collect information through your use of the Portal that would personally identify you unless you choose to provide it. However, you should understand that electronic transmissions via the Internet are not necessarily secure from interception, and we cannot guarantee the security or confidentiality of such transmissions.We may receive and store information you enter at the Portal. The personal information you provide may be used for such purposes as responding to your requests for certain information and communicating with you.We may receive and store certain types of information that does not identify you personally whenever you interact with the Portal. The collection of this information may be through the use of cookies placed on your computer. The information collected may include your IP address and the pages you requested and visited. Coastal uses this data in various ways, including to help diagnose problems with its network, to analyze trends, and to administer the Portal.Cookies are alphanumeric identifiers that we may transfer to your computer's hard drive through your Web browser. Cookies enable our systems to recognize your browser and tell us how and when pages in our Portal are visited and by how many people. Coastal cookies do not collect personal information.Coastal may automatically collect usage information, such as the numbers and frequency of visitors to the Portal. This data is only used in the aggregate and not in a manner that would identify you personally.Coastal may use aggregated information gathered from your usage of the Portal and related statistics in order to improve the Portal and for other purposes. Aggregated information is information from multiple users that does not identify any individual user.SecurityThe security of any data you access via this Portal is important to us. We implement reasonable safeguards to protect your medical information. However, no system is perfect, and all systems are subject to the risks of hacking or other intentional intrusion. Moreover, when you transmit information via the Internet, your information will be transmitted over a medium that is inherently insecure and beyond our control, and therefore the security of the transmission may be intercepted, corrupted or compromised before it reaches us. We are not responsible for any such interception, corruption or compromise of data.You are responsible for maintaining the confidentiality of your username and password for the Portal. Do not disclose your username or password to any other person or entity. If you believe that your username and password has been compromised, please let us know immediately so that we can help you take appropriate steps to protect your medical records. We will not be responsible for any misappropriation or misuse of your username or password.No WarrantiesTHE PORTAL IS PROVIDED "AS IS" AND COASTAL EXPRESSLY DISCLAIMS ALL EXPRESS, STATUTORY AND IMPLIED REPRESENTATIONS AND WARRANTIES, INCLUDING ALL THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT. IN ADDITION, COASTAL DOES NOT GUARANTEE THAT THE PORTAL WILL BE AVAILABLE AT ALL TIMES OR THAT THE USE OF THE PORTAL WILL BE FREE FROM TECHNOLOGICAL DIFFICULTIES, INCLUDING UNAVAILABILITY OF INFORMATION, DOWNTIME, SERVICE DISRUPTIONS, VIRUSES OR WORMS, HARMFUL CODE AND DESTRUCTIVE ELEMENTS.Limitation of Liability; Exclusive RemedyTHE USE OF THE PORTAL IS ENTIRELY AT YOUR OWN RISK. IN NO EVENT SHALL COASTAL BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, EXEMPLARY, PUNITIVE, MONETARY OR OTHER DAMAGES, FEES, FINES, PENALTIES, OR LIABILITIES ARISING OUT OF OR RELATING TO THE PORTAL, SITES ACCESSED THROUGH THE PORTAL, OR CONTENT OR INFORMATION PROVIDED THROUGH THE PORTAL, REGARDLESS OF THE THEORY OF RECOVERY. YOUR SOLE AND EXCLUSIVE REMEDY FOR ANY ERROR IN, MALFUNCTION OR DISSATISFACTION WITH THE PORTAL IS TO STOP USING THE PORTAL.User AgreementYou agree that you will not:1. Upload or transmit any communications or content of any type that may infringe or violate any intellectual property or other rights of any person or entity;2. Use the Portal for any purpose in violation of local, state, national or international laws;3. Use the Portal as a means to distribute advertising or other unsolicited material to any person or entity;4. Use the Portal to post or transmit material that is unlawful, obscene, defamatory, threatening, harassing, abusive, slanderous, hateful or embarrassing to any person or entity; or5. Attempt to disable, "hack" or otherwise interfere with the proper functioning of the Portal.Further, you agree that:1. All information you enter into the Portal or provide in any application to obtain access to the Portal or through any other registration process will be accurate and complete;2. You are eligible to obtain an account for and to access the Portal if you are a patient of Coastal; and3. You will not submit any trade secrets or other proprietary information to Coastal through the Portal.You agree that you will indemnify, hold harmless and, at Coastal's option defend, Coastal and its affiliates and their respective directors, managers, officers, owners, employees, agents, and health care providers from and against any and all claims, demands, suits, actions, damages, losses, liabilities, fines, penalties and costs arising out of or relating to your breach or failure to comply with the provisions of this User Agreement section.Discontinuance of ServicesCoastal is providing the Portal as a courtesy to you, and Coastal reserves the right to suspend or discontinue your access to the Portal for any reason at any time without notice. Coastal reserves the right to modify or discontinue, temporarily or permanently, the Portal, or any part of the Portal, at any time, with or without notice. In addition, Coastal may discontinue your access to the Portal at any time if you violate these Terms of Use or if we determine, for any other reason, that it is no longer appropriate for you to have access to the Portal.MinorsThe Services are available only to individuals who are at least 18 years of age. If you are not at least 18 years of age, do not attempt to register for or use the Services. Coastal may refuse to offer the Services to any person or entity and may change its eligibility criteria at any time in its sole discretion. If you are a parent or guardian of a minor, you are responsible for all access to and use of the Portal on behalf of that minor and are bound by these Terms of Use.Copyright and Trademark InformationAll trademarks, service marks and logos on the Portal are the property of Coastal or its licensors. The content and design of the Portal are protected by U.S. and international copyright laws. You may not copy, reproduce, republish, upload, post, display, or transmit any of these materials without prior written consent from the copyright owners, except that you may view, download, display and print a single copy of limited portions of these materials on a single computer for your personal, medical, noncommercial use only, so long as: (1) you do not alter or modify the materials in any way; (2) you include all applicable notices and disclaimers (including copyright notices); and (3) you do not use the materials in a way that suggests an association with Coastal or an affiliate of Coastal. Title to such materials shall not pass to you or any other person or entity.Third Party SitesThe Portal may permit you to link to other websites on the Internet, and other websites may contain links to the Portal. These other websites are not under Coastal's control. The presence of websites linked to or from the Portal does not mean that Coastal endorses or approves of the information on the linked sites. Further, the privacy and security practices of websites linked to or from the Portal are not covered by these Terms of Use, and Coastal is not responsible for the privacy or security practices or the content of such websites. You are responsible for understanding the terms of use set forth on any linked site.Dispute Resolution; Injunctive ReliefYou agree that any dispute or claim (including a claim for bodily injury or personal injury) relating to your use of the Portal is subject to the exclusive jurisdiction of the appropriate federal or state court in the state of North Carolina, and will be adjudicated pursuant to the laws of the State of North Carolina, excluding its conflicts of laws principles. Coastal will be entitled to an temporary and permanent injunctions enforcing its rights under these Terms of Use in addition to any other remedies available it. These Terms of Use constitute the entire agreement of the parties regarding the subject matter.ContactIf you have any questions regarding these Terms of Use, please contact Coastal at: 252.633.5057.
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