New Patient Paperwork and Forms
At Vidalia ENT Associates, we understand that your time is important to you. To help decrease waiting times, please complete the following forms and bring with you. All forms are in PDF file format. If your computer does not have the Adobe Reader you can download it free here.
A Welcome Letter from Our Practice - Welcome letter.doc
New Patient Paperwork - (3 documents) - patient registration sheet2.doc
PatientFinancialPolicy 2009.doc
Hippa Notification form.doc
Be sure to complete all sections of the paperwork, marking N/A or None where a section may not apply to you.
Bring your insurance card(s), valid drivers' license or photo ID along with your insurance policyholder information; this is the person who holds the policy under which you are covered. The required information is the holder's name, social security number, date of birth and name of their employer. If this information is missing it may be necessary to reschedule your appointment until it is available to you.
Please be aware of your insurance co pay, deductible and coinsurance. All co pays, deductibles, and coinsurance are collected at the time of your visit with no exceptions. As specialist co pays may not cover all diagnostic services performed in the office, please contact your insurance carrier to determine individual benefits.