PLEASE DOWNLOAD THE FOLLOWING FORMS AND BRING THEM WITH YOU TO YOUR FIRST SCHEDULED APPOINTMENT WITH US. MAKE SURE THE FORMS ARE FILLED OUT COMPLETELY. INCLUDED IN THE FORMS YOU WILL FIND AN INSURANCE VERIFICATION SHEET. WE ASK THAT OUR PATIENTS TAKE AN ACTIVE PART IN VERIFYING THEIR INSURANCE PRIOR TO THEIR APPOINTMENT TO HELP BETTER UNDERSTAND THEIR INSURANCE BENEFITS. IF THE INSURANCE IS NOT VERIFIED DUE TO MISSING OR INCOMPLETE INFORMATION, WE MAY HAVE TO RESCHEDULE YOUR APPOINTMENT.
IF YOU LIKE, YOU MAY FAX, MAIL OR E-MAIL YOUR INFORMATION TO US PRIOR TO YOUR APPOINTMENT. HOWEVER, WE STILL NEED YOU TO BRING THE SIGNED ORIGINALS.
Pt Registration PDF
Med Hist PDF
New Pt Cleaning Statement PDF
Financial PDF
HIPAA PDF
Patient Insurance Verification PDF
PLEASE DO NOT HESITATE TO CALL OUR OFFICE IF YOU HAVE ANY QUESTIONS OR CONCERNS.