Copperfield Family Medicine

Copperfield Family MedicineCopperfield Family MedicineCopperfield Family MedicineCopperfield Family Medicine
  • Home Page
  • More About Our Practice
  • Our Doctors
  • For New Patients
  • Education

Copperfield Family Medicine

Copperfield Family MedicineCopperfield Family MedicineCopperfield Family Medicine
  • Home Page
  • More About Our Practice
  • Our Doctors
  • For New Patients
  • Education

For New Patients

Welcome to our office. We're glad you're here. Our staff of professionals is ready to assist you with concerns or questions. It is our goal to provide you with prompt, courteous service.

 


In preparation for your appointment with us, we have several suggestions that should make your visit as pleasant as it can be. We have developed a checklist that all patients should come ready with for their appointment:

 1) Be sure that you have your most recent insurance identification card and a valid driver's license or other form of picture ID.  We will make a photocopy of both.
 

2) Please arrive promptly at (or before) your scheduled appointment time so that we may prepare your chart (we unlock the door at  8:30am).  This assures that there is time for verifying your insurance and checking on any applicable deductible.

3) There will be some forms for you to complete regarding the reason for your visit, medical history, allergies, and medications that you are taking (or have recently taken).  If you do not routinely carry a list of your medications, please prepare one or bring in your medication bottles so that you will be able to provide all necessary information. The FOUR pages of forms (downloads) that you will need to fill out for us prior to seeing the doctor are available in pdf format for printing by separately clicking on ALL of the download links below.

The four forms are also available upon check-in. If you are going to fill them out in our office, please allow extra time to do this before your appointment.

 4)  Payment for services is due upon arrival.  If you are using health  insurance, you will be responsible for your insurance copayment or  deductible at the time of arrival.  For your convenience, in addition to cash, we also accept American Express, MasterCard, VISA, and Discover Card. 

By working together, each visit in our office can flow smoothly and easily. We pride ourselves on punctuality, because your time, like ours, is valuable.

Download #1 of 4

Patient Registration

Registration form (pdf)Download

Downloads #2 and #3 of 4

Health History Pages 1 and 2 (pdf)Download

Download #4 of 4

HIPAA Consent for Purposes of Treatment (pdf)Download

Copperfield Family Medicine

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