New Patient Forms

Please click below to download the forms you need in PDF format

Please arrive ahead of time to fill out a medical information sheet. Please have insurance information available and current, so as not to delay your appointment. We strive our hardest to be on time, but due to emergencies, a slight delay may occur. Please make sure your referrals are current.

Payments:

Payments, including co-payments and deductibles, are expected at time of service. Payment is accepted in cash, check, or credit card.

Insurance:

We accept all types of insurance.

Prescriptions:

Prescriptions are preferred to be written by the doctor at the time of your office visit. If refills are needed, please plan ahead. Prescriptions are not refilled on weekends or after office hours. Prescriptions are not written if the patient has not been seen recently or has a new problem without being seen and evaluated.

Emergencies:

When emergencies arise after hours, go to the nearest emergency room affiliated with this practice. The doctor on call can be contacted by the ER physician or by calling the office number, which is forwarded to the answering service.

Cancellations:

Cancellations would be appreciated as soon as possible and at least 24 hours in advance. This time slot can therefore accommodate other patients. Your appointment can be rescheduled. We do not appreciate “no-shows” and will not reschedule in the future.

Requests for x-rays:

Requests of x-rays require time. Please let us know several days ahead. These will be printed on a disk. There is a charge of $15 for copying a disk.

Disability Forms and Release of Medical Records:

Disability forms take time and are handled within days. Disability forms are not filled out the same day. A charge of $10.00 per form is charged after two forms. Payment is required in advance. Your portion and your employer’s portion must be completed prior to giving the form to us. Requests for records are released only by a sign release form requested by the patient. Copies to an attorney must be requested by the attorney, with signed authorization for release of records by the patient. There will be a minimal charge for Xeroxing and handling. Release of records will require several days.

HIPPA:

We follow HIPPA regulations. Please do not ask us to violate these.