Patient Information/Forms

PLEASE PRINT BOTH ITEMS 

Patient Registration

Medical History

We make every effort to provide you with the finest care and at ease convenient financial options. We will work hand in hand with you and your insurance to maximize your coverage.

Most insurances have coverage for in/out of network. Some can vary on each plan.  Our staff would be happy to help you find out what your insurance is estimated for coverage. You are responsible for charges at the time of service. Insurance plans and payment can be discusses anytime.

*We typically are considered out of network for most insurances. We Are in network with a few plans.

Payment is due at time of service.

Referral Forms:  referral slips

 

Email: frontdesk@paulshowers.com

 

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