Office Policies and Forms
Patient Resources » Office Policies and Forms
Office Policies
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Insurance Participation
Please see our list of insurance providers with whom we are in network here.
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Communication and Appointments
Getting in touch with us:Please call us at 256-533-5211 or log-in to our patient portal if you have any questions, need a prescription refill, or need to schedule an appointment. There is a message service and an on-call physician available for non-emergency, after-hours calls that require a physician response. In cases of emergency, please call 9-1-1 or go to the closest emergency room.
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Labwork and Results
Bloodwork / Lab Appointments:In order to provide you with proper care, all lab work is to be ordered by the practitioner. There may be times when the practitioner feels it is in the best interest of the patient to schedule a return appointment to review these lab results.
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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.
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Payment / Financial
Payment is due at the time of service. We accept Cash, Check, Money Order and Credit / Debit Card payments.
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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 Forms
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Patient Questionnaire
We are currently accepting new patients. If you have not yet been accepted as a patient, please refer to our insurance page to confirm that we accept your insurance and then complete the New Patient Questionnaire through the link below for consideration. After that, someone from our office will contact you. Please be advised that our next available appointments for new patients will begin after January 1, 2027.
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New Patient Forms
We are accepting and scheduling new patients as of January of 2025. If you have not yet been accepted as a patient, please complete the New Patient Questionnaire before proceeding with any of the forms listed below.
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Obtaining Medical Records
There are two different forms to use to obtain medical records.
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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.
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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.
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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.
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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.