About Your Visit
On your first visit please arrive 30 minutes prior to your appointment time and bring the completed forms from the list below. If your insurance requires a referral please bring it to your appointment. We look forward to meeting you!
Also have the following items with you:
- Valid Drivers License or State ID
- Insurance card(s)
- List of medications you take on a regular basis, including over-the-counter medications and vitamins.
- List of surgeries or medical procedures you have had
- Payment for your co-pay or any non-covered services. For your convenience, we take cash, check, VISA, MasterCard, and Discover.
Patient Forms
- Authorization to Release Medical Records
- New Patient Registration Form
- Health and Family History
- Bladder Survey
Financial Policy
- All copays, deductibles, and non-covered service charges are due at the time of service.
- There is a $10 per month statement fee for all balances over 30 days.
- There is a $5 fee to complete forms for disability, insurance, FMLA, etc., which is required before the forms can be completed.
- NSF checks are charged $35.
Urgent / Emergency After Hours Information – If there is a medical emergency dial 911. If you have urgent concerns that occur after office hours please call our office at 248-656-2022 and you will be routed to our answering service. Please note, medication refills are completed during normal business hours only.