成为病人

成为一个新病人, you will need to either contact the office OR fill out the form (attached) and return it to the office by mail, 把它放下来, 或电邮至 S.Brinegar@everystudio.net. If you wish to fax it, please send to 276-403-5484

成为新病人

We are currently accepting new patients into our practice. Thank you for considering us. 成为新病人:

  1. 预约
  2. Sign up for our patient portal
  3. Download your patient forms online through the patient portal

When you come 去我们的办公室 for the first time as a new patient, we'll ask you to complete some initial forms, 包括一个 Authorization and Consent for Treatment form, if you were not able to download them from the patient portal in advance of your appointment.

To make sure there are no delays in care during your 第一次访问 experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.

记得带上:

  • 你的保险卡
  • 有效的带照片的身份证件
  • List of current medications
  • 办公室付费

In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

病人形式

New Patient Application (PDF) – We must have this form completed before we can schedule any new patients with any of our providers. Please print and fill it out, OR you may save as a document and complete, then return 去我们的办公室 by 把它放下来, 扫描/保存和电子邮件, 或者传真到276.666.0400. After a couple of business days, you may call the office to check the status of scheduling an appointment.

注册资料包(PDF) – The form you will need to fill out on your 第一次访问 去我们的办公室. If you would like to fill it out before your visit in order to save time, 请下载, 打印出来, and fill it out with as much information as you can. Then bring it with you to your appointment. If you have any questions while filling out the form, 请给我们办公室打电话, 或者你进来的时候问我们.

Authorization for Release of Medical Information (PDF) – Allows patients to authorize the disclosure of their health information to a designated individual, 公司, 机构, 或设施.

Authorization and Consent for Treatment (PDF) – All patients must provide their consent for treatment, 通信(电话, 电子邮件, 和发短信), and agreement of financial responsibility.

首选联系人(PDF) – Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.

Athletic Participation/Parental Consent/Physical Examination Form (PDF)

办公室的政策

财务政策(PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)

Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)

HIPAA隐私声明