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Patient Info | "Patient Update Sheet"
Patient Update Sheet
For your convenience you may print and complete our Patient Update Sheet. Please bring the completed form with you to your office visit.
Insurance and Billing Information
New patients are requested to pay a deposit of $75.00, if they don't have a co-pay. Insurance information should be given at registration for proper billing to your insurance carrier. While the responsibility for charges is yours, we will as a courtesy bill your primary insurance carrier. We ask that you satisfy any co-payment not covered by your insurance at the time of your visit. A duplicate itemized statement of medical services rendered will be mailed monthly and it is our policy to expect all accounts to be paid within 30 days. If payment is not received in that time or you are unable to pay your account in full, please contact our business office at OR# 503-294-1866 or WA# 360-254-2046 to discuss a payment plan.
