MISSED APPOINTMENTS – If three (3) appointments are missed without contacting our office prior to the appointment time, we can no longer provide medical care to you and you may be discharged from our practice.

LATE ARRIVAL – If you arrive 15 minutes past your scheduled time, your appointment may be rescheduled.

PAPERWORK – Allow 7-10 business days for completion of any paperwork. A charge of $15.00 per form is due BEFORE the paperwork is completed. Please let us know if you plan to pick up the forms or you would like them mailed to your home.

REFILLS – Please allow 24-48 hours for refills to be called in to the pharmacy. Please check with the pharmacy before calling back to the office.

INSURANCE/PRIOR AUTHORIZATION – You are responsible for checking with your insurance company for scheduled procedures (MRI, CT scan, referrals, etc.) Make sure if prior authorization is need, it is obtained BEFORE the procedure is performed.

FOLLOW UP APPOINTMENTS – ALL lab test results will be discussed at your follow up appointment. We will call you with any urgent results.

ANSWERING SERVICE – Our after hours answering service is available for emergencies ONLY. Do not call with refill requests, lost medications, etc. If you do not receive a return call from the on call physician within 30 minutes, please go to the emergency room if it is an emergency.

NARCOTICS AND CONTROLLED SUBSTANCES – All narcotic medications or controlled substances are prescribed at the physician’s discretion. You may be required to sign a controlled substances contract and may be subject to random drug screening.

PATIENT’S RIGHTS: As a patient, you have the right to:

• Participate in the development and implementation of your plan of care.
• Accept or refuse medical care to extent of the law and to change your mind regarding your care at any point.
• Formulate advanced directives, and have staff and practitioners who provide care in compliance with these directives in accordance with the law.
• Have clinical records and personal information kept in the strictest confidence in accordance with the law (HIPPA).
• Receive care in a setting which is safe physically and emotionally.
• Receive care in a manner which is courteous and respectful of your personal values and beliefs.
• Receive reasonable access to medical care and to your medical records.
• Request and receive a detailed explanation of your bill.

PATIENT’S RESPONSIBILITIES: As a patient, you have the responsibility to:

• Provide accurate and complete health information.
• Understand and follow the agreed-upon plan of care.
• Accept responsibility for the outcomes of refusing treatment or note following the agreed-upon plan of care.
• Fulfill your financial obligations.
• Be considerate and respectful of other patients, staff, and their property.