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Patient Resources: Files

Patient Resources

New Patient Form

  • Please print out and complete this form.

  • You may mail it to the provided address or stop in and drop it off.

COVID-19 Policies

  • PLEASE READ BEFORE VISIT

  • Current office policies to comply with COVID-19 safety protocols.

HIPPA

  • Notice of privacy policies and practices.

Office Policies

  • Patient responsibilities

  • Insurance requirements

  • Common service charges 

  • Please read before visit

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  • Make payments to your account or pay off your bill                                                                                                                                         with this safe and secure online payment portal.

  • Don't forget you can always pay in person or over the phone as well!

(419) 991-7805

2875 W Elm St, Lima, OH 45805, USA

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