new and existing patient paperwork

Patient Forms

We want your first visit to be as efficient as possible. Save time by downloading and filling out the new patient paperwork prior to your first visit.

Download Forms

Adult forms are in Microsoft Word format; you will need a copy of Microsoft Word or compatible software capable of opening the DOCX format. Pediatric forms are in the PDF format; you will need PDF software on your computer, although most modern computers sold in the last 12-15 years come with PDF software out of the box. If yours didn’t, download Adobe Acrobat Reader here.

Insurance and Billing Policies

We accept most insurances. We strive to be in network with every insurance that will allow us to be. Since there are thousands of insurance plans we don’t know your benefits, we ask that you call our office so we can verify your provider and plan . If you don’t have insurance, we offer flexible plans as well. We do accept Medicare and Medicaid. Click here to view our No Surprise Act Notice regarding Good Faith Estimates.

All materials on this website including but not limited to text, copy, images and photographs are provided for informational purposes only. This website and related materials are not intended to be a substitute for professional health advice, diagnosis, or treatment. | Good Faith Estimate notice | Text Message Consent

(641) 954-8598

(641) 954-8597 (FAX)

119 W 2nd St., Ottumwa, IA 52501

119 W 2nd St.
Ottumwa, IA 52501

Tel: (641) 954-8598