Immunization Policy

After careful thought and discussion, we have decided to require our patients to vaccinate according to the American Academy of Pediatrics schedule.  We feel this is in the best interest of all of our patients, their families and our community.

 

While there are legitimate reasons to deviate from the vaccine schedule (i.e. serious illness at the time of a well check-up, shortage of vaccine), it is our policy to discourage the spreading out of or splitting up of the vaccines.  If shots need to be given at a time not coinciding with a doctor’s visit, please schedule a shot appointment with the front desk for the shot to be administered by a medical assistant.  Since catch-up administration of vaccines done for non-medical reasons involves additional staff time and is disruptive to the flow of our office, there will be a convenience charge of $50 over and above any co-payment required by your insurance.  This fee is not covered by insurance and is due at the time of service.

 

School & Camp Forms

We are happy to complete any forms needed for school, camp, sports or other activities.  Please bring the form with you to your check-up if possible and we will complete them and return them to you at the end of your visit for no additional charge.  If the patient has a current check-up, the form can be submitted via our website, mail, fax or dropped off in person.  Please complete our School/Camp/Sports Permission Form and submit it with the form you need filled out to assist your doctor.  There is a $15 charge for all forms that need to be completed by the physicians and due to the high volume of forms we receive, please allow us 5 -7 business days to get the form back to you.  If there is a need for the form sooner, there is an additional $10 “rush” surcharge.  Please read all forms before submitting them to us to be sure your child has had an exam within the required time.  We cannot falsify dates.  Please fill out all portions of the parent’s section, especially any medication your child is receiving from another provider.  All forms need to include instructions as to where to send the forms once completed, along with a self-addressed stamped envelope if they are to be mailed.

 

Record Transfers

If transferring to our office from another practice, please request the records be either be released directly to you or sent directly to us from your previous doctor.  We do request that we receive the records from your previous doctor before scheduling an appointment in our office.

 

If transferring out of our office, complete and submit our “Authorization to Release Medical Record” form.  The form should be signed by the parent or legal guardian if the patient is under 18 years of age and by the patient themself if over the age of 18.  There is a $25 fee for the copying and releasing of medical records that is due upon submission of the request.

 

Missed Appointments / Late Cancellations

If you are unable to keep a scheduled appointment, call the office a minimum of 24 hours ahead to cancel or reschedule that appointment.  Failure to cancel your appointment without 24 hours notice will result in a $75 fee.

 

Co-payments and Insurance Cards

At every office visit, be prepared to show your current insurance card and make a co-payment if your plan requires so.  If your child is sent with a childcare provider, please make sure that that person is prepared to make the co-payment.

 

Walk-In Appointments

All visits in our office are by appointment only.  If you need to be seen by one of our physicians, please call the office and we will make our best effort to get you seen in a timely fashion.  We are unable to accommodate patients that walk-in the office without an appointment at that time, but will assess the situation and give an appropriate appointment.

 

Photos & Videos in our Offices

For the privacy of our patients and our employees, we request that you ask the staff before taking pictures or videos in our office  Thank you for respecting this policy.

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