NEW PATIENT INFORMATION

On the day of your first appointment, please arrive at the office 30 minutes early to fill out the necessary paperwork. For directions please see the directions page on this website.

If you require a referral from your Primary Care Physician (PCP), please bring in a copy or verify with us that it has been received. Also, please make sure that your referring physician has sent the necessary medical records so that your physician here can review your medical history.

Checklist of Items to Bring:

• Referral from Primary Care Physician (PCP)
• Photo ID and Insurance Card
• Recent Labs/X-rays
• Medications and Dosages
• Pharmacy Name and Phone Number

RETURNING PATIENTS:

• Please let us know if there has been a change in Address, Phone number or E-mail
• Advise if there has been any change in insurance
• Bring with you an updated medication list and medical history
• Download and complete the RAPID 3 and bring it with you to your next appointment

ACCEPTED INSURANCE PLANS

• Aetna

• AvMed

• BCBS

• Careplus

• Cigna

• Coventry

• Medica

• Medicare

• Neighborhood Health Partnership

• Preferred Care Partners

• Simply Healthcare

• Tricare

• United Healthcare

PATIENT FORMS

• New Patient Questionnaire

• Consent for E-mail communication with patient

• Consent for use and Disclosure of Health Information

• Patient Medical History

• Multi-Dimensional Health Assessment Questionnaire (Rapid 3)

• Financial Policy

• Privacy Notice / HIPAA Form

DOCUMENTOS PARA EL PACIENTE EN ESPAÑOL

• Cuestionario para el uso y aceso de su
  información de la salud

• Historial Médico

• Cuestionario de Evaluacion del Estado de salud
  (Rapid 3)

• Consentimiento para comunicación via correo electronico con el paciente

• Poliza Financiera

• Privacy Notice / HIPAA Form