Forms & Payment
Accepts new patients
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Medical insurance plans and payment options
Accountable PPO, Admar PPO/EPO, Accountable (Interplan Health), Aetna Health Plans PPO/HMO/TRS, Affiliated Health Care PPO/EPO, Affordable / First Health PPO, Blue Cross Blue Shield PPO/HMO/Traditional, Beech Street PPO, Beech Street/Focus (Work Comp), Best Doctors, Cigna Healthcare PPO/HMO, Comminity Health Choice, DirectCare America PPO, Freedom of Choice Memorial Employees, Galaxy Health Network PPO, Great West PPO/HMO, Health Smart PPO, Humana PPO/HMO/Choice Care PPO, Independent Medical Systems, Medcorp Southwest PPO, Multiplan PPO, National Health Alliance PPO/EPO, National Preferred Providers Network PPO/EPO, Pacificare, Plan Vista Solutions, PPO Next, PHCS, Provider Select, ProNet, Three Rivers, Southwest Preferred Network PPO, Unicare PPO/HMO, United Healthcare PPO/HMO/POS,
Payment for office visit, as well as radiological and laboratory testing is expected at the time service is rendered. You may pay in the form of cash, check or credit card. Insurance will be filed for you at this time should you so desire.
Office information from Michael G Kaldis, MD
Cervical Spine / ShoulderPlease complete this form if your chief complaint is regarding your neck and/or shoulder.
GENERAL FORM
PATIENT HISTORY FORM
Patient Demographic Form
Patient Demographic Form to be completed by all patients and turned in at the time of your scheduled appointment.
Thoracic And/Or Lumbosacral Spine Form
Please complete this form if your chief complaint involves your mid-back and/or low back.