Patient Resources

Patient Resources

Office Policies and Forms

  • Insurance Participation
    *At this time, our relationship with  United Health Care, Cigna, Humana, and a few other insurance networks is limited to existing patients only. *
  • Third Party Forms
    We realize that special forms are sometimes necessary to provide documentation of medical conditions.  Completing forms is time consuming and generally falls outside the contractual relationship between you and your insurance company.  All forms requested without an appointment will need to be reviewed by the office to determine if an appointment is necessary.  Please drop them by the office with a phone number so we can contact you when a determination is made.  Fees for these types of forms will vary according to the complexity of the paper work.
  • Prescription Refills
    Before you come to your regular appointment, you should look over your medications, diabetes supplies, inhalers, etc. to determine if you need to request any new / refill of prescriptions at your appointment.
  • Patient Questionnaire
    While we are not currently accepting new patients, we sometimes request our patients to update their information.  If this has been requested of you, please forgive the absence of an online form as we are working towards creating a new one.  One of our staff members will contact you if additional information is required.
  • New Patient Forms
    All new patients *who have already scheduled an appointment*, please print and complete the following forms and bring them to your first appointment. Otherwise, you can arrive 15 minutes before your first appointment so we may give you the forms to complete in our office:
  • Privacy / Information Release

    Your privacy is very important to us.

    • We are unable to release any information regarding healthcare, appointments, billing or insurance information to your spouse, parent, family members, significant others or friends without written authorization from the patient. 
    • If you would like us to speak to anyone other than yourself regarding any of these issues, please print the medical release to family member form and return it to our office. 
    • Patients over the age of 14 years must sign for themselves.
    • To learn how we use and protect any of your information, view our Notice of Privacy Practices here.
  • Wellness Health History

    When our Medicare patients schedule your wellness exam, please fill out the Wellness Health History form and bring it with you to your wellness check.  Otherwise, please arrive in time to fill it out in our office before your appointment.

  • Living Will / Advance Directive
    An advance directive is a written instruction that you make while you are mentally competent that states how you want your health care decisions to be made if you become incapacitated or cannot express your wishes. Advance directives guide your physician and other health care professionals, and relieve your family from the burden of guessing what types of care and treatment you would want to receive.  
  • Patient Survey
    We've been serving the medical needs of the Tennessee Valley for quite a while now, and we continually strive to achieve a positive patient experience. While there are some things we can't control (like insurance changes or regulations that we are required to meed), we look forward to hearing your thoughts about how we are doing and how we may improve.

Frequently Asked Quesitons