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Our Office Staff Welcomes you to our Practice:

Please read the following important information:

We request that new patients Download, Print, & Complete all of the forms shown on the Downloads Page. The completed forms should be brought with you to your first appointment. Click the link below, for the Forms Download Page.

Download Page

Additional Important Information:

(please read completely)

Patient Bill of Rights:

As a patient, you have the right to be treated fairly and honestly.

You have the right to be treated on an emergent basis when warranted.

You have the right to quality and timely treatment regardless of age, sex, religion, or national origin.

As a Provider, we reserve the right to:

Discharge you for not adhering to practice policies after a 30 day written notice.

Discharge you for abusive treatment to our staff.

Discharge you for routinely missing appointments and not calling to cancel.

Discharge you for activities considered potentially fraudulent or abusive by your carrier or the government.

Inform you if a procedure may not be covered by your insurance, a signed ABN will be required. 

As a Patient you are Required to:

Pay Co-payment and/or Deductible.

Be present for all appointments 15 minutes prior to scheduled time for paperwork and financial agreements.

Present you insurance information/changes to our practice at each visit.

Clear all prior balances before receiving additional treatment.

Your Insurance Carrier Requires you to:

Pay Co-payments.

Pay Deductible amounts.

 

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Last modified: January 08, 2014