For your convenience, we have provided the following patient forms which you can print, complete and bring to your initial visit (Please click on the links below to access such forms). The following forms are in PDF format.

Patient Registration and Medical History Form
Financial Policy Form
Notice of Privacy Practice
Signature Form



PATIENT INFORMATION

Appointments and Cancellations
What to Bring to Your Appointment
Insurance and Payment Information


Appointments and Cancellations

We realize that our patients’ time is valuable, and we make every effort to see patients at their scheduled appointment time. We ask that patients provide as much advance notice as possible when running late for an appointment or when needing to cancel an appointment. With this advanced notice, the time can be scheduled for another patient in need of care.


What to Bring to Your Appointment

If you are a first-time patient, please plan on arriving early in order to complete some forms. In order to expedite such registration process, please print and complete the available downloadable forms and remember to bring them for your visit. Please also bring the following items to the appointment:

Insurance card(s)
Referral forms (if required)
List of all your current prescription and over-the-counter medications
X-ray films and reports (or any other relevant test reports)
Payment for any unmet deductible, co-payment or co-insurance obligation


Insurance and Payment Information

We are a provider for Medicare, Medicaid and most major insurance plans. Unfortunately, we currently do not accept Workers Compensation in our office. Since we provide insurance billing, we encourage all patients to confirm their coverage prior to making an appointment. We collect payment at the time of service(s). Co-payments, unmet deductible and co-insurance are due at the time of service. You are ultimately responsible for any unpaid balance not paid by your insurance, and such payment is due within 30 days from receipt of our statement. We accept payment in the form of cash, check and credit card transactions. We accept VISA, MasterCard, Discover, and American Express. 

Please call us with any questions regarding which insurance plans we accept or other billing concerns. Insurance coverage and benefit questions should be directed to your insurance carrier.

Please bring a signed copy of our Signature Form form with you to your appointment.


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