Full name (including middle initial)
Date of birth
Cell phone number
Current Active insurance information
Purpose of the appointment
Please call our office as soon as you realize you will not be able to keep your appointment. We prefer all cancellations be made at least 24 hours prior to your scheduled appointment time. This will allow us to give another patient the opportunity to be seen.
Our physicians and nurses are with patients throughout the day, so it is usually not possible for them to immediately answer phone calls. We will return your call as soon as possible. To help us get back to you quickly, leave us your full name, date of birth, reason for the call and current phone number.
Blood pressure checks are provided free of charge. However, if it is not controlled, there will be a fee for service rendered. Please call the clinic for an appointment today.
Our registration staff will ask you to fill out registration and health history forms. We ask that new patients arrive 30 mins before scheduled appointment time to complete your paperwork.
Please bring all your current medications, your insurance card or copy of your card. If your insurance requires a co-pay/deductible, please be prepared to pay to your consultation. In addition, it is helpful to write down a list of questions for your provider so that we can ensure that we answer all of your questions during the visit.
We ask that you contact your pharmacy to request a refill. If there's no more refills, please call the office for an appointment or Telemed with the Physicians to review your medical record before prescribing or refilling any medications. Please note that any new medications may require a patient visit. Finally, all controlled substances require an in-person consult eash month.
Each insurance plan is very different. Therefore, we recommend that you contact your insurance to determine if the anticipated service are cover with your individual plan. We are only able to provide quotes for office visit. If the services are not covered, we can work with you to develop a payment plan.
Tele-PrimeHealth services allow you to virtual conference with the physisican via a secure video on your phone or computer. Tele-PrimeHealth visits are a great way to have meet your needs without coming into our office! This service is offered to patients that do not require a physical exam. Most insurance plans cover the video appointment.
We can assist for a nominal fee. Forms can be dropped off at the front desk or through email. Depending on the type of form, like FMLA, Disability and Life Insurance may take up to 5 days to be completed. Some paperwork might require an appointment with your physician for completion.



