Sunday, 05 September 2010
 
  Home arrow New Patient Forms
 
 
Main Menu
Home
About our Practice
Billing Policies
Information
Letters of Praise
Contact Us
Spotlight
New Patient Forms
Directions
Northern Kentucky
Finneytown
Wilmington
New Patient Forms PDF Print E-mail
As a courtesy to you, we are willing to check your benefits. Ultimately you are responsible for knowing what your coverage is. Should your plan require an authorization, you will need to obtain that prior to your first visit. Please call the number on the back of your insurance card to fully understand your coverage. We accept most major insurances, please contact and we will be happy to answer any specific questions related to your policy.

We do the best we can to ensure the accuracy of the benefits and we need your help to make sure the insurance company’s quote is accurate.

All of our forms are available through links below. These forms need to be printed out and brought in at your first visit.

You will be asked to provide a credit card to secure payment. These services are confidential and secure. We accept Visa and MasterCard. If you do not have a credit card, you will be asked to secure a cash deposit.

1) Patient Registration pdf doc
2) General Consent pdf doc
3) Medical History pdf doc
4) Online Insurance Information Sheet pdf doc

Please read the following documents to understand our office policies and HIPPA laws: Office Information, HIPPA Laws, Late/Cancellation Fees
 

© 2010 Postive Pathways, LLC
Joomla! is Free Software released under the GNU/GPL License.

Get The Best Free Joomla Templates at www.joomla-templates.com