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NEW PATIENT REGISTRATION
MEDICATION
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Refills are done on 72 hours notice Mon. - Thurs.
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Yearly prescription slips (i.e.) birth control pills, given at the time of your annual appointment actually need to be taken to your pharmacy. The medication order cannot be OK’d by telephone after the appointment. When we receive a request from a pharmacy to OK these annual medications, it is our
reminder that you need to return for a repeat pap or your annual appointment.
PAYMENT
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We accept checks made out, by you, to Lila Schmidt MD INC and cash only. To ensure accurate credit to your account; cash payments must receive a signed receipt. Checks serve as their own receipt, however one is provided upon request.
COMMUNICATION
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Let us know how we may address you, Title (i.e. Ms., Miss, Mrs., or Attorney), First name and or Nickname.
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The more active you are in your healthcare, the healthier you will be. Thus you call us for test results at a predetermined date/time, scheduled before you leave your appointment. If it is after hours Dr Schmidt will
give you her home phone number.
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We welcome your comments, if you have a concern, please let us know how we may improve. If you have a compliment let your friends know. We accept ALL PPO insurance plans at no additional cost to thepati ent, (ask us how). Again, we welcome you and look forward to assisting you in your healthcare.
REGISTRATION FORM
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