Financial/Forms
Thank you for choosing our practice. We are committed to the success of your medical treatment and care and strive to keep your costs reasonable and manageable.
With offices in Port Royal, Bluffton, and Hampton.


Financial Policies
For your convenience, we accept several forms of payment, including the following:
- Cash
- Personal Checks
- Money Orders
- Visa
- MasterCard
- American Express
- Discover
Our office manager and/or insurance coordinator can assist you further should you have additional questions.
We currently contract with Medicare, BCBS, TriCare, MailHandlers, Workmans Compensation, and Medicaid just to name a few.
If you are not sure about your coverage, please contact your insurance provider to verify that we are in network with your plan.
If you have an HMO with which we are not contracted, then payment is required in full for office visits, office procedures, and other charges at the time of the visit. Our staff will provide the necessary information for you to complete and file your claim directly with the insurance company.

Patient Forms
To help expedite your visit with us, please download, print, and complete necessary forms prior to your scheduled appointment. To ensure you are seen quickly and on time, we request that all new patients and those returning after three years complete the New Patient Registration form, New Patient Questionnaire, and HIPAA Statement before your appointment time.
If you are returning for a follow-up visit, please complete the Follow-Up Visit Questionnaire prior to your next visit. If requested by your doctor or our staff, you may also need to complete the Headache Patient Intake Form.
For patients requesting medical records from our office or who need their records sent to us from another medical provider, please complete and submit the Patient Records Release Form.
- New Patient Registration
- New Patient Questionnaire
- HIPAA Statement
- Follow-Up Visit Questionnaire
- Headache Patient Intake Form
- Patient Records Release Form

Financial Policies
For your convenience, we accept several forms of payment, including the following:
- Cash
- Personal Checks
- Money Orders
- Visa
- MasterCard
- American Express
- Discover
Our office manager and/or insurance coordinator can assist you further should you have additional questions.
We currently contract with Medicare, BCBS, TriCare, MailHandlers, Workmans Compensation, and Medicaid just to name a few.
If you are not sure about your coverage, please contact your insurance provider to verify that we are in network with your plan.