PatientWeb

Account Access

Please provide the requested information below in order to set up your account. Required fields are marked with a *.

An account representative will review the information provided, after which you will receive a verification email regarding your account status.

If you are an individual requesting access for a practice already belonging to PatientWeb, please contact your account administrator.

This form is for new provider account requests only. If you are a patient, please request access from your provider.

Practice Information
User Information
Account Access
❌ At Least 8 Characters
❌ Contains Uppercase Letter
❌ Contains Lowercase Letter
❌ Contains Number
❌ Passwords Match
User Agreements

PatientWeb is now part of Rialto Insights. We are excited to continue supporting the providers, organizations, and patients who rely on PatientWeb while expanding the platform with new capabilities and enhanced services through Rialto Insights. As part of this transition, all new users are required to review and accept our legal agreements before accessing the platform.

Services Agreement View

The Services Agreement outlines the terms governing your organization's subscription to the Rialto Connect platform, including the services provided, customer responsibilities, security commitments, and general terms of use.

Business Associate Agreement (BAA) View

The Business Associate Agreement describes how Rialto Insights protects and manages Protected Health Information (PHI) in accordance with HIPAA. It also includes the Data Rights Agreement, which explains the use of HIPAA-compliant de-identified data as permitted by applicable law.

I CONFIRM THAT I HAVE FULL AUTHORITY TO EXECUTE THESE AGREEMENTS    
I CONFIRM I AM NOT A ROBOT    

Please make sure the Agreements are signed by a representative of the Dental Practice that has full authority to execute and deliver these agreements on its behalf.

If you are not an authorized user, please enter the name and email address of an authorized person. We will send them an email with a request to log in and sign the agreements.