Proliance Surgeons
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What should I bring to my appointment?
Please have the following ready when you come to your appointment:
If Applicable:

For Patients New To Our Practice

Please complete our New Patient Information and History form. You may submit our new online form OR print and fill out the 2 PDF forms below and bring them with you to your appointment.

Online version: New Patient Information and History Online Form
Printable version: 1) New Patient Information PDF 2) New Patient History PDF

* After your visit, please be sure to visit our links page to complete our patient satisfaction survey, and to download post-surgical instructions.

We are Preferred Providers (PPO) with the following health plans:

If you do not find your plan amongst those listed, feel free to contact us to verify that we accept your insurance.

Billing Procedures:
We will bill your health insurance company directly. You will receive a bill from us after the insurance company has processed your payment to the physician. We request payment of co-pay at the time of physician visit. Payment is required at the time of service for patients without health insurance. We are members of most health care plans and we accept assignment for our Medicare patients. Patients who receive surgical services through our Surgicenter may be required to prepay part of the insurance plan deductible or co-insurance and set up a payment plan for the balance due after insurance payment receieved. All other balances are due upon receipt of our billing you following insurance payment.