New Patient (Spanish)
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New Patient
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Patient Screening Form (Spanish)
 
Practice Policy Acknowledgement (Spanish)
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Practice Policy Acknowledgement
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To provide you the best health care possible and to make the most of our time together, it is important for you to prepare in advance for your visit. We want this to be a positive experience for you, therefore, follow the steps below to ensure your visit goes as planned.

Patient Forms

New patients, please print and complete the forms located here. Submit the completed documents when you check-in at the receptionists desk.

Medications

Bring ALL of your medications, not just your allergy medicine.

Insurance card

Bring your health insurance card.

Physician referral

If your doctor referred you to us, bring the referral document.

Medical records

If you have them, great bring them. If not, we’ll request them.

Appointments

If you’re unable to keep your appointment, kindly give 24 hours advance notice to avoid the $50 no show and short cancellation notice fee.

Payment

You are responsible for the co-payment, co-insurance and/or deductible at the time services are rendered.

Our team has the professionalism and experience you and your family can trust. New patients will benefit from knowing What To Expect.

Patient Assistance Program

Learn about Merck's Patient Assistance Program, Aimed at helping those in need.  Read the Program Overview.

Coupons

Find out if you are eligible for a coupon which could help you save on your medication.  Read about the Coupons Here.

 

 

 
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