Consent to Treat
Our office policy is that a parent or legal guardian must accompany a minor (less than 18 years of age) at all times. This is our policy for several reasons:
- To assure that the information we obtain is correct.
- To allow you to hear our findings.
- To have you available to consent to tests or immunizations/procedures.
- To allow you to learn about the expected course and what complications to watch for.
In today's world of working parents, it is sometimes necessary for nannies, friends or relatives to bring a child in to be seen. It is also sometimes necessary for an older teen of driving age to come by himself or herself. In these cases, please complete a Consent to Treat form or a Power of Attorney form.
Consent to Treat Minors
Consent to Treat Adults
Power of Attorney Form
Please plan ahead for prescription refills. We encourage you to address refills at the time of your office visit. Any changes in medication, new prescription, or mail-in prescription problems require an office visit. No prescription refills will be granted on weekends, after hours, or during routine well visits.
We respect your time and every attempt is made to run on schedule. Therefore, we ask you to arrive on time for your appointment. If you are late, you may be asked to reschedule. If your provider is running behind due to emergencies and you need to reschedule, please notify the office staff. If you choose to stay, your visit will be given the same consideration.
Our policy is to collect payment in full for services at time of the visit, including all co-pays due. For your convenience, we are pleased to accept cash, check, MasterCard, VISA, Discover or American Express. If you need to arrange a payment plan, please contact our billing department.
Charges for professional visits, procedures, medications and lab tests are determined based on the time spent, the cost of supplies, and the complexity of the problem.
Scheduled consultations or well visits cancelled with less than a 24-hour notice will incur a $50 charge billed to you; missed appointment charges are not covered by insurance plans.
For patients on one of the HMO/PPO plans to which we belong, our contract requires that we submit insurance forms upon receipt of your co-payment (if required) at the time of the visit.
We are open to serve you, answer questions or schedule an appointment during the following hours:
Mon 09:00 am – 07:00 pm
Tue 09:00 am – 07:00 pm
Wed 09:00 am – 05:00 pm
Thu 09:00 am – 05:00 pm
Fri 09:00 am – 01:00 pm
Sun By Appointment