Patient Paperwork

Patient Paperwork – Required At Your Appointment
To ensure a smooth check-in process, all new patients must complete the required paperwork prior to their scheduled appointment. If you DO NOT already have a scheduled appointment, please call our office at the phone number below. 

New patients must also bring a current list of medications, insurance cards and any helpful medical records and/or prior testing. Please also plan to arrive 15 minutes prior to your scheduled appointment. 

We offer three options to submit your completed forms:

  1. Complete online through this website.
  2. Download, print, and bring the completed forms to your appointment.
  3. Email the completed forms to [email protected] prior to your visit. Subject line: Patients Full Name and Date of Birth.

For your convenience, the following is a list of insurance companies with which we are currently contracted. This list is subject to changes. Preparing in advance helps save time and improves your overall experience.

Accepted Insurance Plans:

  • Aetna Medicare PPO
  • Aetna PPO
  • Anthem Blue Cross PPO
  • Blue Cross / Blue Shield PPO
  • Florida Blue PPO
  • Cigna Life
  • Cigna Open Access Plus
  • Medicare (NO United Health or Baycare Medicare)
  • Meritain Health – PHCS and First Health Plans
 

New Patient Registration

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Once you reach our billing page please hit the "Quick Pay" button.

Then enter your patient information.  Your Responsible Party Account # is your account number shown on your statement.