On your first visit, plan to spend the first few minutes filling out a patient information sheet, as well as reviewing and signing release and acknowledgement forms. The forms are provided here for your review and convenience. Also, a photo will be taken of you and stored in our records to assist in the prevention of identity theft.
- Patient Information Sheet-03-01-2014
- Patient Consent to Treatment 09-23-2013
- Notice of Privacy Practices 09-23-2013
For patients who are uninsured or underinsured we offer a Sliding Fee Program which is based on household size and income. Forms below.
What To Bring
Please bring these items with you for your first visit:
- Completed forms (see above)
- State Authorized Photo ID
- Insurance Provider Card
- Your current medications (prescriptions and over-the counter) in their original bottles.
In the meantime, if you have a question, please contact us.