For New Patients
All of our facilities are teaching facilities. During your visit you may be interviewed, examined and/or treated by a resident or a medical student under the supervision of one of our doctors, who are all faculty members of the Boonshoft School of Medicine. And there are advantages for you:
To schedule an appointment, call (937) 245-7200.
At each visit you will check in with our receptionist, who will need to copy your insurance card(s).
If possible, please download, print and complete our registration and patient history forms, and bring them with you to your first appointment (doing so will save time in the waiting area). To view the files, you need Adobe Reader, a free download.
The Registration Form will become part of your medical records. It is important that you complete all of the sections, date and sign the form. (Please bring this form with you to your first appointment. This will save waiting time.)
You will also need to fill out the Health History Form to the best of your ability (Please bring this completed form with you to your appointment).
Insurance Filing and Payment
We are happy to file your insurance for you. We strive to process each claim accurately and efficiently. Please bring your insurance card(s) to each visit, and notify us if there has been a change in your insurance. It is important that you know your insurance plan's limitations. Patients whose plans have a co-payment will be required to pay the designated amount at the time of service. Family Medicine accepts cash, personal checks or credit/debit cards.
Checklist of What to Bring to Your First Appointment
Other forms you may need:
Below are some of our standard office forms to assist you in your visit.
Fees for Services