Today is Thursday, September 09, 2010
Today's date:
Thursday
September 09, 2010
Thursday, September 09, 2010
09/09/2010
Thursday
09/09/2010
September 09, 2010
September 09
09-Sep-2010
Home
Medical Staff
Services
Locations
For Patients
Login
Sitemap
Contact Us
About Us
Medical News
New Patient Forms
Test & Aftercare Instructions
Insurance & Billing
FAQs
Useful Links
Ask a Question
Schedule an Appointment
Request a Prescription Refill



For Patients

Prepare for a New Patient Visit

To save you time during your visit, print the following forms, and complete them in the comfort of your home. Bring the completed forms to your appointment. If you cannot complete this paperwork in advance of your visit, we ask that you arrive 30 minutes prior to your appointment.

Patient Registration Form Patient Registration Form
Patient Medical Information Form Patient Medical Information Form
Patient Record of Disclosures to Family and Friends Patient Record of Disclosures to Family and Friends
Notice of Privacy Practices Notice of Privacy Practices
Acknowledgement of Notice Acknowledgement of Notice

In addition, please bring the following to your appointment:

New Patient Visit Insurance card
New Patient Visit Referral forms and co-payments, if required
New Patient Visit All current medications in their original containers
New Patient Visit Copies of pertinent diagnostic tests and medical records
New Patient Visit If you have had cardiology testing at another facility, please have copies of these tests and any other pertinent reports sent to our office prior to your visit




Terms and Conditions | Feedback | Privacy Statement
Developed and hosted by Cardiology Domain.
© Copyright 2000-2010. NorthPoint Domain Inc. All rights reserved.
ICS-PR-WEB01