What To Bring At Your Appointment - New Patients Form

NEW PATIENTS

• Valid health insurance card
• Photo ID or driver’s license
• Current List of all Prescribed, over the counter or Herbal medications including dosage and directions (if possible bring medication bottle) at every visit.
• Bring correct form of payment (Cash, Visa or MasterCard) for your Co-pay deductible or co-insurance
• Please fill out the appropriate information below, if applicable to you.