Forms & Policies

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Patient Forms

Signature Medicine offers you a choice in the level of service provided with your medical care.  See our medical services section for a detailed description of both service levels:  traditional and concierge medicine.  As a new patient, regardless of service choice, please help us get to know you and your health concerns by downloading and completing the new patient forms:

• Download and complete the forms in the New Patient Welcome Kit well before your office visit.  These forms include:
• New Patient Registration
• New Patient Medical History
• Patient Authorization Consent with Privacy Notification Policy
• Download, read and consider signing the email authorization form.  If you choose to sign this form, you will be able to have email communication with Signature Medicine.
• If you want to become a member of the Concierge Care program complete click here.

Patient Policies & Insurance

Test Results

• In keeping with best medical practice, we do not believe in the "no new is good news" approach to our patient test results.
• Any patient who has not heard back from the office regarding test results within 1 week, should call the office for those results. 

Financial

• We expect your co-payment to be paid at the time of your visit.
• We accept cash, check, Visa & MasterCard
• It is essential that you bring your active insurance card to each visit
• It is important that you notify the office anytime your information (personal demographic or insurance) changes.

Insurance

We participate with most major insurance plans and Medicare.  Please contact our office prior to your first visit just to make sure that your insurance plan is accepted. 

• Aetna
• Cigna
• Devon Health
• Coventry Health Care / HealthAmerica/HealthAssurance
• Humana
• Great-West Healthcare, Inc
• Independence Blue Cross
• Medicare
• Private Healthcare Systems (PHCS) / MultiPlan
• United Healthcare

*If your insurance is not listed, please call the office. 

Prescription

• Renewal requests will be filled Monday-Friday during business hours with at least 48 hours advance notice.
• Renewal of certain medications require office visits to monitor progress and prescription use

Privacy

• Please see information under the HIPAA notice in the Welcome to the Practice Kit