Form Requirements
To provide you with the best care, we require specific documentation for different medical services. For primary care visits, please ensure your patient history and current insurance card are up to date. For specialized services like physical therapy, a medical referral form and a signed treatment consent are necessary before your initial evaluation.
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Double-check that your name, address, and date of birth match exactly what is on your insurance card.
Step 1: Verify Info
Step-by-Step Instructions
Filling out insurance paperwork shouldn't be stressful. Follow these three simple steps to ensure your claims are processed quickly and accurately.
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Enter your member ID and group number carefully. These are often found on the front of your card.
Step 2: Policy Numbers
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Sign and date the form where indicated. An unsigned form is the leading cause of claim delays.
Step 3: Signature
Glossary & Tips
Deductible
The amount you pay for covered health care services before your insurance plan starts to pay.
Co-pay
A fixed amount you pay for a covered health care service, usually when you receive the service.
Coinsurance
Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service.
Downloads & Submission
Download Forms
Obtain all necessary insurance paperwork in one click. Please review the instructions before filling them out to ensure accuracy.