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pATIENT FORMS

 

new/established

 patient 

All of our forms are available for download. You can fill them out and return them electronically, by mail, by fax, or by dropping them off at the office. 

RECORDS RELEASE FORMS

Forms are available for your need to request records.

Click here to request e-mail to electronically sign relevant clinic forms to your care. 

Please note we may require a signature on more than one form and they will all load together. If you fill out new patient paperwork on line we may send you an e-mail to securely sign relevant forms electronically. We will also need a scan of a picture ID and insurance card. Please note these forms are an annual requirement.

Insurance

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We accept most insurance carriers. 

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We are preferred providers for most private insurers including Aetna and Blue Cross. 

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If your insurer requires a referral for sub specialty care please obtain one from your primary care provider.

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If you have any questions about your insurance, please contact our office and we will gladly assist you.

 

As a courtesy to our patients with medical insurance, we will file insurance claims on your behalf. This requires signing the insurance assignment form which can be securely electronically signed by e-mail.

 

Please provide us an up-to-date medical insurance card. A photo or scan of the card can be e-mailed to us if you do not come to the office. Depending on the medical insurance you carry, you may have to pay an office visit co-pay at the time of service and you may have a deductible. If you are unsure of what your medical benefits are, please contact your employer or medical insurance provider.

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Payment is expected at the time of service. We accept cash, checks, Visa, and MasterCard.

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Telemedicine

At present most insurers are covering telemedicine for both new and established patients. We plan on continuing telemedicine services after the COVID crisis.  

 

What You Will Need:

  •  A computer or tablet with a webcam or a smart phone with a camera.

  •  Google Chrome or Mozilla Firefox web browser.

  • Please read and sign our telemedicine consent prior to your appointment. This can be done electronically through e-mail.

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How Telemedicine Works:

  • 5 minutes prior to your appointment time, click on your Dr.'s Telemedicine link.

  • Make sure your microphone and camera are activated

  • You will be waiting in a virtual lobby.

  • Your Dr. will click on your name at your scheduled appointment time or as soon as they are finished with the prior appointment.

  • If you are having issues connecting please call the office to let us know.

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Telemedicine Links:

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