Patient Center
Our patient forms are available for you to print at home, fill out, and bring with
you to your appointment to save in the waiting room.
If you are a new patient, all the forms are bundled into this one click for you:
Individual Patient Forms
- Patient Registration Form
- Medical History Form
- Financial Policy
- HIPAA Patient Acknowledgement
- Formulary Benefits Data Consent
- Informed Consent to us Patient Portal
Insurance
Verify with your insurance company that they are contracted with us. Most insurance cards have the customer service phone number on the back. Additionally, you can check the website of your insurance company.
- Aetna/US Healthcare
- Blue Cross Blue Shield
- Cigna
- Humana
- Medicaid
- Medicare
- MultiPlan
- PHCS (Private Health Care System)
- Tricare - Standard
- United Healthcare
- WellCare
Privacy
Your privacy is important to us. Your private health information is protected by law. Here is our privacy policy that outlines how your information may be used.
Resources
Up To Date is an excellent patient resource regarding kidney disease. Visit UpToDate.
The National Kidney Foundation has an excellent website with some outstanding patient resources.
To learn about treatment options for kidney failure log on to Fresenius Medical Care patient education site.