During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.
Patient Forms
Please print and fill out the New Patient forms so we can expedite your first visit.
New PatientsPlease have the following items available during your visit so we can complete your initial paperwork:
- Patient's insurance card
- List of current prescriptions and/or over-the-counter medication, including dose and frequency
- Information about patient's medical and surgical history
- Recent test results, x-rays, or relevant records
Insurance and Payment Information
Dr Chalnick accepts Original Medicare Part B only. For private patients, self-payment by cash or credit card is accepted. Please call our office to verify acceptance of your insurance carrier.
You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please call. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
