I put the code into SSMS and it underlines red for the first + sign on the first line and the PatientID next to Convert.ToInt32. the code is large so I'm only posting half of it since the error is on the first line.
"if not exists (select PatientID from patienttable where PatientID = " + PatientID.Text + ") begin INSERT INTO patienttable VALUES (" + Convert.ToInt32(PatientID.Text) + "','" + OldID.Text + "','"
+ PtLastName.Text
+ "','" + PtPreviousLastName.Text + "','" + PtFirstName.Text +
"','" + HomeAddress1.Text + "','"
+ HomeAddress2.Text + "','" + HomeCity.Text
+ "','" + HomeStateProvinceRegion.Text + "','"
+ HomeZip.Text + "','" + Country.Text + "','"
+ Citizenship.Text + "','" + PtHomePhone.Text + "','"
+ EmergencyPhoneNumber.Text + "','" +
PtHomeFax.Text+ "','" +Pager.Text+ "','" + EmailAddress.Text
+ "','" + PtSS.Text + "','"
+ DOB.Text + "','" + Gender.Text + "','"
+ EthnicAssociation.Text + "','" + Religion.Text + EthnicAssociation.Text + "','" + MaritalStatus.Text + "','"
+ "','" + EmploymentStatus.Text + "','" + HospitalMR.Text + "','" + DateofExpire.Text + "','" + Referral.Text + "','" + CurrentPrimaryHCPId.Text + "','" + Specialist1.Text + "','" + Specialist2.Text + "','" + Specialist3.Text + "','" + Specialist4.Text + "','" + OriginalStaffHCP.Text + "','" + CurrentStaffHCP.Text + "','" + Active.Checked + "','"
+ Comments.Text + "','" + DateEntered.Text
+ "','" + BusinessPhone.Text + "','" + BusinessFax.Text + "','" + SubscriberRelationship.Text + "','" + EmployerID.Text + "','" + NextOfKinID.Text + "','" + PtMiddleInitial.Text + "','" + NextOfKinRelationshipToPatient.Text + "','" + NoticeOfPracticePrivacy.Checked + "','" + NPPDate.Text + "','" + Suffix.Text + "')