Patient Forms

You may now download and complete our PATIENT FORMS from the convenience of your home or office. This will expedite your appointment process. Simply click on the form below, print, complete and bring into our office on your appointment date. Please call our office if you have any questions.

>> CLICK HERE TO DOWNLOAD NEW PATIENT FORM

Accepted payment types

We welcome cash, check and most major credit cards as payments. However, to offset bookkeeping expenses, office must assess a fee for each "insufficient funds" check returned to us.

Past Due Balance

An account is considered to be "delinquent" after 60 days. If you receive a final notice from us, you must pay your balance in-full. If we do not receive payment after sending a final notice, we will be forced to send your account to a collection agency and/or list your failure to pay with the Credit Bureau.

Billing Polices

We comply with all guidelines set fourth be Medicare, Medicaid, and participating HMO, PPO, and POS plans.

We appreciate the fact that understanding health insurance coverage can sometime be complicated and confusing. Knowing your insurance benefits will help clarify your responsibility and will aid with possible non-covered services.

Many insurance companies will pay only what they consider to be usual and customary charges. This varies by insurance company. In such cases, you are responsible for any remaining balance.

If you do not have insurance coverage, you must pay for all services within 45 days. You will receive one statement. Payment must be forwarded upon receipt of payment.