Patient Forms
(New Patients Form) (Suboxone New Patients Form)
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.
Listed below are a set of initial patient forms. These forms can either be filled out (using an internet browser) and e-mailed, or printed out and hand filled then submitted when coming to the office.
NOTE: The above documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.
Initial Visit (Intake Form) (Health Information Release)
On your initial visit, please plan to arrive at least 15 minutes before your appointment time to allow ample time to complete our new patient forms or, for your convenience the forms are provided above (click form in brackets) so you have the option to print and complete these forms at home.
Appointments
Our offices are opened Monday-Friday from 9:00am-5:00pm. Our offices are closed on week-ends. We also ask that you give us 24 hour notice before canceling or rescheduling your appointment. Our office will assess your account $50 appointment cancellation or no-shows of your appointment time, so please, whenever possible call our office.
Payment Policy (Financial Consent Form)
We accept most major insurance plans and are a Medicare provider. Your insurance company may also require a co-payment or deductibles are due at the time of service. We accept Master card, Visa, and Discover, as well as personal checks.
What to bring to your Appointment
- Physician referral forms if required by insurance
- Any information about past surgical and medical histories
- A list of current prescriptions or over-the-counter medications you are taking
- Your insurance Card and personal form of ID such as a driver’s license
- Contact information form your doctor(s), therapists and pharmacy.
Insurances We Accept
- Aetna
- BHO/HPN (PPO/HMO)
- Cigna
- ComPsych
- Coventry Health Care
- Culinary
- First Health Insurance
- Anthem Blue Cross
- Medicare
- The Loomis Company
- Tricare
- Sutter Select
- Tri West
- Value Options
- Magellan Health
- Medicaid
- Mines & Associates
- Multiplan
- Nevada Health CO-OP
- NV. Preferred/GEHA
- Teacher’s Health
- UMR
- Humana
- United Health/United Behavioral
If your insurance is not listed above, please contact us for further information. We would be happy to assist you!