Office Policies

Form Completion Policy

If you need to have forms completed by your health care provider please be aware of the following:

  • Depending on the nature of your form, you must have had a complete physical in the last 12 months or you will need to schedule one in order for us to complete your form.
  • If you need a prior authorization form for your insurance company to pay for your medication you may need an office visit, depending on the individual form.
  • You will be charged either $15.00 for short forms or $50.00 for long or complex forms. (this is not covered by your insurance)
  • If your form asks for immunization history you must supply us with a copy of your shot records or have labs drawn to provide proof of your immunity status.
  • You will need to bring your form with you to your appointment, we do not have MVA, camp, school, adoption or other forms.
  • We cannot complete forms over the phone.
    p. If you are uncertain what applies to your particular form please ask our receptionist to review your form and direct you appropriately.

Missed Appointment Policy

There is a $25.00 charge for all missed regular office visit appointments and a $50.00 charge for all missed physical appointments not cancelled at least 24 hours in advance.

Prescription Renewal Policy

Please be sure to get any medication renewals that you will need between now and your next appointment while you are here today.

When a provider writes a prescription for medication it is for the quantity they believe will last until the next time you are due to return. When you reach your last refill it is time to call and schedule your next appointment.

Referral Policy

  • You must have been seen by one of our healthcare providers in the last 12 months.
  • We must have a current copy of your insurance card & up to date registration form on file.
  • You must request your referral two business days in advance of when you will be picking it up.
  • If the referral is at the direction of another healthcare provider you must supply a copy of the order with your request.
  • If the referral is for radiology, physical therapy or chiropractic care it must be ordered by a healthcare provider.
  • Please leave your name, daytime contact number, current insurance provider, diagnosis or reason for referral and the spelled name of the specialist or facility to whom you are requesting a referral.
  • If you wish your referral to be mailed to you, you may leave self addressed, stamped envelopes at the front desk for your chart.