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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.

 

 

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We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.
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