request the following from new patients
Fill & sign -
Patient information, Authorizations, HIPAA, patient history form (click to download)· Arrive 30 minutes before scheduled appointment time.
Old records release request can be downloaded and handed to your previous
physician’s office. If you have lot of records it will take several visits to
get all that information into our system. (click to
Bring your insurance
card - We will call your insurance company to verify coverage & deductibles
- any deductibles will need to be paid prior to being seen - if payment not
made we reserve the right to cancel/reschedule the appointment.
We reserve the right to
charge $150 at visit to the NEW PATIENT while waiting for the insurance to pay,
this will be applied as a credit after payment is received from the insurance
company and refund of credit can be issued.
Copays & Deductibles are due prior to the visit; we will not bill you
for this. We accept cash, checks; Credit cards involve a transaction fee.
HSA (Health Savings
Accounts), Insurance cards with VISA logo will be considered as self-pay and we will charge them at
appointment, we will also submit the charge to your Health Insurance company and after we receive the EOB the account will be
Bring any previous
medical records if available.
Bring ALL your medication
BOTTLES (just a LIST is not enough).