First Appointment Preparation
In preparation for your first appointment, please download the patient forms (pdf format) below. Please print out and complete the forms before your visit. Bring them with you to your appointment. For your convenience, you may open the "All Patient Forms" pdf file and print entire list instead of opening each individually.
Patient Forms
Patient Registration Form
Patient Medical History Form
Consent for the Use or Disclosure of Protected Health Information
All Patient Forms
Notice of Privacy Practices
Please arrive 20 minutes early to allow us ample time to complete your paperwork, including making copies of your insurance card(s) and photo ID.
Our doctors are specialists. If your insurance requires a referral, we must receive this before your appointment. If not received, you must sign a waiver and pay for all charges at the time of your appointment. This does not apply to Medicare, unless you have an HMO Medicare plan. If your insurance plan does not require a co-pay, a $75.00 first visit payment is required for a new patient. If you have MEDICARE OR MEDICAID you will not be required to make a payment at the time of your visit.
If you do not have insurance, an amount of $275.00 will be required prior to seeing the doctor. After your appointment, the collection of any remaining balance is required. A refund will be given if appropriate.
We will need to know the hospital your insurance plan covers for any testing, procedures, or surgeries that may be necessary. Please have this information at the time of your visit. This will not apply if you have Medicare or Medicaid.
If you have any questions, please feel free to call our office.