Patient Center

Download, print, and fill out these forms at home in order to expedite your visit:

• Patient Portal

If you are a new patient, all forms are included in this ONE new patient welcome package:

• New Patient Welcome Package

** IMPORTANT INFORMATION PLEASE READ**       

FINANCIAL POLICY - 2011

Patient co-pay and account balance is required to be paid at time of arrival. 

·        Un-met deductibles:  $75.00 charge (inclusive of co-pay) will be charged. This amount will be applied to today’s visit .

·        All Surgical patients:  $250.00collected at check-in, day of surgery. This payment will be applied to the surgery and pathology reading fees. Fees not covered by patient’s insurance company are the responsibility of the patient. Any credit on patients account after reimbursement from the insurance company will be reimbursed to the patient in the form of a check.

·        Elective Surgical Patients:  Patients choosing elective surgeries with unmet insurance deductibles, will be required to pay full surgery fee on the day of surgery.

·        Surgical Self Pay Patients :  Are required to pay $250.00 at check- in , with any balance due at check- out, on the day of surgery.

·        Cosmetic procedures and consults:  There will be a $150.00 consult charge at check-in, this will go to the credit of service received. Balance, if applicable, is due at check-out.