NEW PATIENT PAPERWORK

PLEASE PRINT OUT AND BRING TO YOUR APPOINTMENT.


IF YOUR INSURANCE REQUIRES AN AUTHORIZATION, PLEASE MAKE SURE TO HAVE THAT INFORMATION EITHER SENT TO OUR OFFICE OR PLEASE BRING WITH YOU TO YOUR APPOINTMENT ALONG WITH ANY MEDICAL RECORDS THAT YOU MAY HAVE.


PLEASE ALSO MAKE SURE TO BRING YOUR INSURANCE CARDS, PICTURE ID, AND MEDICATION LIST WITH YOU.


THANK YOU AND WE LOOK FORWARD TO MEETING YOU.

Viera Heart and Vascular Clinic