Patient Resources & Appointment Preparation

Thank you for choosing the INSERT NAME HERE. It is our every desire to provide you with excellent and timely service. The following guidelines were designed to facilitate this process.

ON THE DAY OF YOUR APPOINTMENT:

Please complete the downloadable forms and bring completed to your appointment. click here for Maps and Directions to our Locations.

• Please arrive 15-20 minutes prior to your scheduled appointment time. This will allow us to complete the registration process in a timely manner.
• Please note that arriving late may result in your appointment being rescheduled.
• Please bring your current insurance card to every appointment.
• If your insurance requires prior authorization/referral, we will need to have this on file before you can be seen.
• If you arrive for your appointment and we cannot verify your insurance coverage or authorization, you may pay in full at the time of the visit or reschedule your appointment.
• Be prepared to pay your co-payment at every visit.
• Your co-payment amount is normally indicated on your insurance card.
• For your convenience our office accepts checks, money orders, and all major credit cards. We no longer accept cash payments at any of our offices.

Patient Forms & Downloads

Please print and complete the following forms:

New Patient Forms	Return Patient Forms	Additional Office Forms
New Patient Form 7.50 Kb Registration Form Patient Services Guidelines Email - Phone Service Guidelines Urgent After Hours Appointment Guidelines Privacy / HIPAA Form Summary Agreement	Registration Form (Complete entire form if there have been changes to your demographic or insurance information. If there are no changes, complete only the highlighted portions) Patient Services Guidelines Email - Phone Service Guidelines Urgent After Hours Appointment Guidelines Privacy / HIPAA Form Summary Agreement	Appointment Policy Cancellation Policy CEI Business Policy Master Agreement Policy Dizziness Questionnaire Medical Release Form Summary of Changes
Forms Require Free Adobe Reader Software - download here if needed