New Patient Information Sheet



Looking for a new primary care provider?



Our Nurse Practitioners
Sarah Cooper and 
Heather Hamilton are
accepting new patients
and have immediate availability.



The acceptance of new patients varies upon the availability of openings specific to each individual physician.   We welcome you to complete an information sheet in order that you might be put on our waiting list.  A member of our staff will notify you as openings become available.  **Please be advised that completion of this form is for informational purposes only and does not imply establishment of medical care with our facility.

   


Welcome to Woodway

Thank you for choosing Woodway Internal Medicine.  We are very appreciative that you have chosen our facility as your new health care provider. 

To better assist our patients we have compiled some basic information to facilitate a smooth process on your first visit.  You will be mailed a new patient packet to read and complete prior to your initial visit with our practice.  In the meantime, please follow the instructions below to make your visit as easy as possible.


  •  Arrive 15-20 minutes early for registration

  •  Bring all Health Insurance cards

  •  Bring a picture ID

  •  Bring the completed patient information sheet

  •  Bring the completed patient intake form

Once again, welcome.  We look forward to providing your health care needs.


Patient Responsibilities

Effective health care requires patient involvement and responsibility.  To ensure the best possible treatment and results, we ask that you:

Complete all the health history and information forms that we give you.  Provide as much information as possible about your current health, medical history and family history.  Tell us all you know about any chronic illness, health history, current medications, and any medication allergies.  Be sure to include any over the counter medicines as well as herbal supplements.  All of this information is compiled into a cutting edge electronic medical record that will assist us in treating you while in the office as well as maintaining continuity of care with any medical specialists you may need to see in the future.

Communicate with us.   Our staff makes every effort to provide you with all the information you will need to understand and complete your medical treatment plan.  If you do not understand what our staff is saying or you do not understand your treatment plan, please tell us; we want to ensure that all everyone has a clear understanding of their treatment plan.  If you choose not to follow the treatment plan recommended, let your practitioner know of your decision.

Keep your appointments to ensure your care is complete.

Let us know as soon as possible if you must cancel an appointment so that we may offer your appointment time to another patient.

Accept responsibility for your actions if you decline treatment or do not follow your practitioner's instructions.

Report unexpected changed in your condition to your practitioner.

Ask your doctor or nurse how and when you will receive results from tests or procedures ordered or performed by our facility.

Keep us updated on your insurance coverage.  Meet your financial obligations to Woodway Internal Medicine and your practitioner.


Billing and Insurance Information

The business office at Woodway Internal medicine strives to provide the same high quality, efficient service to our patients as our medical staff.   Medical regulations change rapidly, and we do our best to keep up to date on the latest information to assist our patients with their financial and insurance needs.

Please check our Frequently Asked Questions section for assistance with many of the typical questions you may be having.  Please feel free to contact our billing office at any time for questions about your patient statements or other concerns.


 

Prescription Refills

* Please Plan Ahead *

There is a mandatory 24 hour notice on all refills. 

No refills will be called in after hours, over the weekend or during holidays.  Our refill line is available 24-hours a day for your convenience.  Please leave the following information.

  • Name and your date of birth

  • Phone number

  • Name of the medication needed

  • Prescription number as available

  • Name and location of your pharmacy

Written prescriptions and requests for samples will be handled in the same manner.  Refill requests dropped off at the front desk may be picked up the next day.  To save yourself a trip, please call ahead for your written prescriptions.

Please specify the need for a 90 day supply with 3-refills if you have a mail-in prescription. 

Remember you must see you doctor once annually to have your medication refilled.


Cancellation Policy

Effective January 1, 2000 the office of Woodway Internal Medicine will require a 24 hour notice for cancellation of appointments.  In the event that a 24-hour notice is not provided the patient will be charged a $25.00 fee.  Two consecutive occurrences of a patient not keeping an appointment without the required 24-hour notice, or three occurrences within one year will result in the patient being discontinued from the practice. 

 

All new patients failing to show for their initial physical examination without giving the required 24-hour notice will be unable to reschedule with any physician within the practice.

Please contact our office at 289-5006 to notify us if you need to cancel or reschedule your appointment.


 


 
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 Woodway Internal Medicine    4000 W Woodway Drive     Muncie, IN  47304     (765) 289-5006
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