Patient Information

Billing and Financial Obligations

We make every effort to decrease the cost of your medical care, Therefore, we request payment arrangements for all services at the time they are rendered unless prior arrangements have been made. We accept cash, checks, MasterCard, Visa, Discover, and American Express for your convenience. If we are a participating provider of your insurance company, we will bill them. However, payment is ultimately the patient's responsibility. We will help in any way we can to assist you in handling claims.

Appointments/Cancellations

With the exception of serious emergencies, it is expected that you keep all of your appointments. In the event that you need to cancel your appointment, kindly provide 24 hours notice. Your consideration in this matter will allow us to accommodate other patients who could benefit from an appointment.

Patient Forms

We recommend that you print and complete the necessary forms prior to your new patient appointment. Patients may be asked to complete the Consent for Non-Guardian(s), Pediatric Intake, and Urogynecology Medical History Forms in addition to the standard Registration forms depending on their age and/or condition.

Please be sure to bring a list of your current medications, a Photo ID, and your insurance card(s) (if applicable) to every scheduled appointment.

  • Consent for Non-Guardian(s).pdf
  • Consent Form.pdf
  • HIPAA Detailed Policy (READ ONLY).pdf
  • Medical History Form.pdf
  • Pediatric Intake Form.pdf
  • Registration Form.pdf
  • Urogynecology Medical History Form.pdf

Note: These files are in PDF format. If you do not have Adobe Reader on your computer, you can download it for free by clicking here.


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