Forms and Insurance Info

Forms

The following forms are available upon request:

• Patient registration
• Insurance
• Initial History
• Follow up Medical Forms
• Authorization for Medical Treatment
• Privacy (informational)
• Notice of Privacy sign off
• Financial Policy
• Credit Card Authorization
• Records Release Outgoing
• Photo Authorization
• Cancellation Policy

Patient portal will be available soon – please check back.

Insurances Accepted:

Most insurance accepted. If the doctor happens to be out of network, we will assist Dr. Saukin’s patients with insurance reimbursement whenever possible.