The forms that we require for all new patients are provided below. Feel free to print these forms and fill them out prior to coming for your visit.
Home Medication List
Make sure the list is accurate with amount and frequency.
Include your pharmacy name and telephone number.
Allergy list will also be needed.
MRIs, X-rays, EMG or any reports that would aid in your diagnosis.
If you have had a previous surgery, we will need your operation report.
These items can be obtained from the place you completed them or from the physician who ordered the study.
We do have the technology to view discs on computer.
You can mail them to our office once your appointment has been made.
Mail in plenty of time so we receive them prior to your appointment.
Call to ensure we have received them prior to your appointment.
What is my diagnosis?
If you don’t understand, ask for explanation or a teaching sheet
What is causing my symptoms?
What other symptoms might I experience?
What do I do to help myself get better?
Will physical therapy or exercises help with my condition?
What is my physical limitations?
Do I need to take medications for this?
Always speak with your medical doctor prior to starting any medication.
Do not ask for medication that you typically receive from other physicians.
Set up appointment time prior to leaving the office.
If you need to change the date or time, please call 24 hours in advance.
If you are returning for a result, call to see if we have it prior to your visit.
Ask the doctor about when to return prior to leaving the office.
AARP
Aetna
BCBS
Beech Street
Cigna
American Republic
Bankers Life and Casualty
Combined Insurance
Conseco
United AMerican
United Teacher Association
TICUA
Humana
Medicare
PHCS
Railroad Medicare
Freedom Blue
United Healthcare
Unicare
Royal Neighbors
Windsor Medicare Extra
Health Partners
Assurant
Caremark
AMerican Health Group
NALC Health Benefits
Sterling Investors
Pittman & Associates
Great West
Lincoln Heritage
Benefit Administrators
Reserve National
Amerigroup
Medicare Advantage Plans