New Patient Paperwork
For your convenience, a printable version of our new patient packet is available online. You may print and complete the forms prior to your visit. Bring the completed forms with you to when you come in.
If you are not able to complete the forms before your visit, please allow at least 30 minutes for completion in the office before you see the doctor.
Current Medications
Please bring all 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.
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Insurance Co-pay
Find out what the office visit co-pay is for your particular insurance plan and be prepared to pay that amount at the time of your visit.
Payments
Payments can be in the form of cash, personal check or credit card. We accept MasterCard, Visa, Discover and American Express.
Payment Policy
Payment is expected at the time service is rendered. Your insurance company requires you to pay your co-pay at the time of service. The cost of billing, which we are unable to control, is constantly increasing. In order that we may keep our fees as low as possible, we are trying to eliminate billing. If you request to receive a bill, we will add an additional $5 for billing charges. An account which is past due and for which no payment arrangements have been made will be forwarded to a collection agency. Collection agency fees will be the responsibility of the patient.
There is a $30 charge for all returned checks.
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