Forms
Our forms are in Adobe format. You may download Adobe Reader for free at www.adobe.com.
New Patients
Please print, complete and bring the following forms when you come in for your visit:
form, appointment policy and financial policy)
Adult History Questionnaire
Pediatric History Questionnaire
Established Patients
If your address or insurance information has changed since your last visit, you can print, complete and return the following form:
Additional Forms:
Columbia County Sports Physical Form (pdf)
Medical Record Release Form
Policies
Insurance Cards
We ask that you present your insurance card when you check-in for each of your visits. This allows our staff to verify our office has your correct information on file and helps to decrease insurance filing errors. If you do not wish to provide your insurance card upon check-in, we will ask you to pay for your visit at the time of service
Payment for services
We expect our patients to pay for their visits at the time the services are rendered. This includes your co-payments, deductibles, and co-insurances. Our office gladly accepts cash, credit cards, debit cards and checks.
Prescription Refills
Our office can generally process your refill request within 72 hours. We ask our patients to call our office a week prior to running out of their medications.
Referrals and Authorizations
Please allow 72 hours for our office to process referrals or prior-authorizations required by your insurance company. Our office will not back-date referrals. We ask our patients to contact their insurance companies to verify if a referral is necessary for specialist visits. Please inform our staff if you will need a referral for an upcoming appointment.