Welcome New Patients!
We accept new patients from birth to geriatrics. Our practice participates in most insurance plans, including Medicare and Medicaid; however, we only accept patients with Medicaid under the age of 12 years old. All new patients are required to pay a $50.00 “good faith” pledge that they will keep their scheduled appointment. This fee can be applied to your deductible, coinsurance, or copay once we file your insurance. Our practice requires that all copayments, deductibles and co-insurance be paid at the time of service.
If you would like to be considered for a new patient appointment, please fill out the two forms below. You may bring the forms to our office, or email them to: OM@unifourfamilypractice.com
If you are accepted by one of our providers, you will be notified via phone and an appointment will be scheduled at that time.
For Your First Visit…
New patients are to arrive 20 minutes prior to their appointment, bring a valid ID (driver’s license), their current medications, a list of drug allergies, and their insurance card. Please download and complete all new patient forms from our website, or complete the New Patient Welcome kit sent to you and bring to your initial appointment. If you neglect to bring these forms with you, you will be required to complete all of the necessary forms, prior to being seen.
Under HIPAA (Protected Healthcare Information Compliance Act), you will be required to have your picture taken and downloaded into our EMR system. If you are unable to keep your appointment, you must notify our office 24 hours in advance in order to avoid a No Show charge.
