Appointment Information
Business Hours
9:00am to 5:00pm Monday – Friday
Arrival Time
Please arrive 10 – 15 minutes prior to your appointment time and bring the following information:
- Completed forms
- List of medications, vitamins, herbs or nutritional supplements that you take on a regular basis. Please include the dosage information or you may just bring the bottle with you and we will record them.
- Any MRI, CT, X Ray films or CD’s for your physician to review.
- List of questions you may have for your doctor.
Please bring the following information to your visit, if you have not already faxed or brought this information to the practice prior to your scheduled visit:
- Insurance card(s)
- Drivers license or other photo identification
- Completed patient history form
- Completed privacy form
Contact Person
Anita Larick, Referral Coordinator (419) 483-2403, ext. 114 9:00am – 4:30pm
Payment Policy
It is our payment policy to collect the appropriate payment due from the patient at the time the service is rendered. This may only be your co-payment, deductible and/or co-insurance, but we do ask for payment at the time of your visit. We accept all major credit cards.
Co-payment – The cost-sharing part of your bill that is a fixed dollar amount designated by your insurance company that is your responsibility to pay at each visit (also known as “co-pay”). Common co-payment rates are $10 or $20 per visit, but be aware that co-payment rates vary from insurance company to insurance company.
Deductible – The amount of cost sharing that you must pay for medical services often before your health insurance company starts to pay.
Co-insurance – The part of your bill, in addition to a co-pay, that you must pay. Co-insurance is usually a percentage of the total medical bill—for example 20 percent.
Cancellation Policy
If you must cancel your appointment please call (419) 483-2403 at least 24 hours in advance. If you fail to do so you will be charged a $25.00 fee. If you must cancel a testing appointment, please call (419) 483-2403 at least 24 hours in advance or you will be charged a $75.00 fee.