Forms + Insurance

Office Forms

The following forms are available online for your convenience. Simply click on the form name to view and print that online form. Please fill out all printable forms and bring them to the office with you.

For New Patients Only

In order to provide you the best possible service, please complete the new patient intake form below. This will allow us to better understand your care needs, verify your insurance coverage and eligibility, and check for physician availability.

Download Documents

Click a button to download a printable PDF version of that document. Each document will open in a new browser tab.

Accepted Insurance

We accept the following insurance plans.

• Medicare RailRoad
• PHCS/Multi Plan
• Tricare Certified
• United Healthcare
• UMWA
• VIVA