Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you.
Save time by printing your forms now and fill them out before you come in.
Patient information forms (3 pages total) Part 1 / Part 2
Click the links above to open a PDF file that you can save to your computer. Please sign the form and bring it with you to your first visit, along with your insurance card.
You must have Adobe PDF reader to view and print this file. Click here to install if you do not have this.
If for some reason you are unable to open a PDF file a hard copy will be available in the office prior to your appointment.
• For our physicians to treat you most effectively, we will ask you to fill out a patient information questionnaire at your first visit. Please bring information about past and current medical treatments and illnesses you have had, including approximate dates. Please have your primary care doctors name and number.
• Know if you have met your insurance company’s deductible. If you are not sure, call your insurance company. A toll-free number will be on your insurance card.
• If you are a Medicare patient, remember there is an annual deductible that must be met.
• You will be responsible for the amount of co-payment at the time of treatment. We accept cash, checks, debit/credit cards (MasterCard/Visa).
• If you are insured with a HMC (Heath Management Corporation) you will need a referral from your primary care physician before we can treat you. Please contact your insurance company to see if a referral is required before scheduling and have your PCP fax the referral to our office.