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Below is the information we need from you at your first office visit.

• Insurance card
  We will not file your insurance without a card. If you do not have a card, payment is expected at the time of service.
• Reports and films
  Provided to you by another doctor or medical facility. If films should have been sent from another medical facility to this office prior to your visit, please call this office prior to your visit to confirm they are here.
• Check, cash or credit card
  To pay your deductible and co-insurance.

Please review and sign these forms, then bring them to your first office visit.

• Financial policy  (14 KB)
• Patient registration form  (14 KB)
• Medical surgical and social history form  (72 KB)
• Notice of Privacy Practices Acknowledgement  (17 KB)
• Medical Malpractice Agreement  (20 KB)

To view these forms

Please use the Adobe reader. It is free software, available here.



If you need any additional information, please call us at (919) 850-0880.