Forms & Payment
Accepts new patients
| Medicare | Medicaid | Workers' compensation | Other |
|---|---|---|---|
Medical insurance plans and payment options
We offer Cash discounts and honor "Out of Network" plans. Most Private Plans are also accepted.
Office information from Ross P Nathan, MD
HIPAA DisclosureAbout our commitment to maintaining your privacy
Release of Information Authorization
Disclosure regarding who is allowed to receive patient information
Additional Insurance Coverage
For patients with two insurance plans or more
General Disclaimer Form
General Disclaimer Form
Medical History
Patient Medical History
Medicare Disclosure
For Medicare patients only
Patient Registration form
Patient Demographic Information (*note: for patients with more than one insurance plan, please also complete "Additional Insurance Coverage" form
Contact Information
Other staff in my practice