Forms & Requests

We accept most insurance plans, however, it is the patient's responsibility to verify the providers participation with their individual plan. If the provider does not participate with their plan the patient will be responsible for the non covered charges. Our office is not accepting the affordable care act plans.

Click Here To Fill Out The New Patient Packet Online or

Click Here to download the new patient paper work (printable version)

Medical and Wellness services are provided by appointment only.

When calling our office for prescription refills, please allow 24-48 hours for processing. You can also have your pharmacist electronically fax an order for refills to our office at fax number (386) 774-0606, but this turn around time can sometimes be longer than the 24-48 hour allotted time frame.

Keep in mind our office is closed on weekends and holidays. Please allow enough time for your prescriptions to be refilled. We ask that if you know you are running low on a medication to call our office a week prior to running out to give us the proper time to fill the prescription request.

We do charge a $25.00 no show fee for patients who schedule appointments and do not notify us within 24 hours of not being able to keep their appointment.

A charge of $25.00 is collected for all forms that need to be completed by the physician for other outside entities (example: disability parking permit form) if the forms are not done during a regularly scheduled appointment.

Our New Patient policy: Please come by our office for the new patient packet, fill out the new patient packet online, or download the new patient paper work on this site and complete fully and send to our office. Once your new patient packet has been reviewed we will have our staff call and make your appointment.

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