CSIMIS

Description

which includes your past history. Please fill out the form and print it, sign it and bring it with you in order to expedite the check-in process. You need to provide us with your insurance card, if applicable, referral from your primary care physician. Workman’s Comp patients will need to get prior authorization from their nurse case managers. We’d like to have all past medical records relating to your condition and all radiology films. CO-PAYS will be collected at the time of the visit. Currently we do not accept Credit Card Payments.

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