For your convenience, you may complete your patient forms in advance. Please click the appropriate link from the options below, fill them out completely and simply submit! We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.
If you are not able to complete the forms before your visit, no worries! We assist each patient personally with their forms and medical history. If you are looking for an office that hands you a stack of paperwork and pen to fill out on your own, you won’t find it here!
Current Medications
Please bring a list of any medications you are currently taking to your appointment.
Personal Identification Needed
Be sure to have your valid driver license and insurance card(s) with you.
Payment Policy
Due to recent changes in healthcare plans, some patients have questions regarding patient and insurance responsibility for services rendered. Our rates are representative of the usual and customary charges for our area. Please review our payment policy information below. You will be provided with a copy of this information to read and sign at your office visit. Please let us know if you have any questions or concerns.
Insurance
We participate in most insurance plans, including Medicare. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, we will obtain information during your phone call to schedule to verify your coverage prior to your exam. You will also need to present your current card at your office visit. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.
Co-payments and deductibles
All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment and/or deductible at each visit. Payments can be made in the form of cash, personal check or debit/credit card. We accept MasterCard, Visa, Discover and American Express.
Coverage changes
If your insurance changes, please notify us before or on your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay within 30 days, you will be responsible for the balance.
