Patient Intake Forms

Fill Out Forms In Advance and Streamline Your Care.

GROUP OR INDIVIDUAL INSURANCE

We accept all major health insurance carriers. We will gladly verify your benefits when you schedule an appointment. If you have any questions regarding your financial responsibilities at our office, please ask.

PATIENTS WITH HIGH DEDUCTIBLE OR NO INSURANCE

Many patients have high deductible insurance, or have plans with limited or no coverage. We have several payment options for patients to receive care without financial difficulty. We do accept cash,  personal checks, MasterCard, Visa, Care Credit or Discover cards.

AUTOMOBILE ACCIDENTS

We do accept and bill all auto insurance carriers.  Please notify your auto insurance carrier of your visit to our office.

MEDICARE

We do accept assignment from Medicare. Medicare pays 80% of the allowable fee. You are required to pay the deductible and the remaining 20% as well as any non-covered services.

MEDICAID

We do accept assignment from Medicaid. Medicaid pays 100% of the allowable fee for 20 visits annually.

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