New Patient Forms

If you like, you can download the following to forms, complete them, and bring them with you for your first visit.

Patient Registration Form

Release of Records Form

NEW PATIENTS WELCOME

WE DO HOUSECALLS

No insurance accepted

-FEE SCHEDULE-

DUE TO THE PANDEMIC,
WE ARE SCHEDULING ONLY TELEMEDICINE APPOINTMENTS OR HOUSE CALLS
New Patients . . . . . . . . .$110.00
Yearly Checkup . . . . . . .$110.00
30-minute follow up. . $110.00
15-minute follow up . . .$55.00

If you have insurance, you may be able to apply the fee to your deductible, request reimbursement, or charge it to your Health-Savings Account.

-OFFICE LAB-

In-office lab tests, like urinalysis and

Rapid Strep are included at no extra charge

-TIME FOR YOU-

Doctors who take insurance have to limit the amount of time they spend with patients. Since I don’t take insurance, YOU decide how much time we spend together.

-FAMILY & FRIENDS-

The highest compliment you can give is to refer your family and friends.

-NEW PATIENT FORMS-

Patient Registration

Release of Records

-IN HOUSE PHARMACY-

We keep a selection of common prescription medications for sale in the office, so you don’t have to go to the pharmacy.

-PATIENT PRIVACY-

All patient charts are on paper. We don’t use electronic medical records, so your private information can never be hacked or held for ransom. We won’t send your records anywhere without your written permission.