The following forms will be needed for your initial office visit. To save time, you can fill them out in advance and bring them with you.
Either type in the answers on each screen and then print out the completed form for signature, or print out the empty forms and then write in the answers by hand.
We require all new patients to provide a valid drivers license with a current address and updated insurance card - you must show proof of address with a license or a utility bill etc.
INSURANCE:
We provide for the following insurance companies:
- Aetna Indemnity, PPO, HMO
- Aetna World Bank
- Beech St., Healthlink
- Carefirst BCBS PPO and HMO
- Cigna
- Coventry
- Federal Bcbs
- First Health
- Guardian (only If through PHCS, or Alliance)
- Greatwest
- Geha
- Mail Handlers
- Mamsi Life and Health Insurance Company (only)
- Md-Ipa (requires referrals unless preferred)
- Medicare
- Multiplan
- Mutual of Ohama
- Ncppo
- Onenet
- Optimum Choice
- Phcs
- Railroad Medicare
- Tricare (only if it’s secondary insurance coverage)
- Unicare
- United Healthcare (insurance not Medicaid)
All commercial insurance not listed that includes out of network coverage is accepted.
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