Get a jump on your new patient paperwork. To save time, you can download and print our forms, fill them out,and fax them in or bring them with you for your first appointment. We look forward to meeting you.
Appointment Checklist (12 KB)
Symptom Review Form (74 KB)
Medical History (195 KB)
Patient Registration (57 KB)
PREPARING FOR YOUR APPOINTMENT
1. Your first visit to our office is a comprehensive evaluation that may take as long as one or two hours.Dr. Strickland will review your medical records and mammograms, ultrasounds, etc.She will complete a detailed risk assessment for patients with a family history of breast cancer, and a thorough breast exam will be performed.
2. Wear comfortable clothing to your appointment.You will be asked to undress from the waist up.A robe will be provided, and your exam will be performed with attention to modesty.
3. You are welcome to bring a friend or family member with you.It is often helpful to have some else with you to take notes and help you remember questions.
4. In order to get the most out of your appointment and avoid disruption to our other patients, we ask that children under the age of 12 not accompany you to the appointment.If it is absolutely necessary to bring them with you, please ask a family member or friend to accompany you and watch the child/children while you are in the exam room.
5. You will be asked to complete several new patient registration forms.To save time, you may download and print our forms here.Completed forms can be faxed to 334-593-9094 or emailed to firstname.lastname@example.org. If you are unable to print the forms, we will be happy to mail them to you.If you are going to complete your forms upon arrival to the office, please arrive 30-45 minutes early to allow ample time.If you complete the forms in advance, we ask that you arrive 15 minutes before your scheduled appointment to allow time to input your information into our system.
7. Bring your insurance card and photo ID.We must have a copy for your medical records.
8. Co-pays are due at the time of your visit.Payment may be made by cash, credit card, or check.
9. If your insurance requires a referral from your primary care physician to see a specialist, it is your responsibility to obtain that referral before you come to your appointment.If you do not have this referral, we may need to reschedule your appointment.You should contact your insurance company directly to verify whether or not a referral is required.
10. IF YOU HAVE HAD A MAMMOGRAM OR ULTRASOUND at a facility other than Baptist Breast Health Center, Jackson Imaging Center, or Montgomery Breast Center, PLEASE BRING THE FILMS/DISK AND REPORTS TO YOUR APPOINTMENT.You may not be seen if you arrive without these films and reports since they are necessary for the doctor to use in making her diagnosis and recommendations.
11. As a courtesy, we will file your insurance claims for you and will communicate with your insurance company to resolve payment issues.However, some circumstances may require that you communicate directly with your insurance carrier to resolve claim issues.
12. There is a $15.00 charge for filling out medical forms such as FMLA and Disability.These forms must be delivered to the office in person—forms sent via fax or mail will not be accepted.There is a 7 to 10 day turnaround time for completion of forms, and we will contact you by phone when the paperwork is complete.Your paperwork must be picked up in person; we will not mail or fax these forms.Please understand this policy is in place to allow us to provide better service to you, so that forms are not forgotten, misplaced, or lost in the mail.This process allows us to track your paperwork closely and provide a more timely and accurate turnaround.