You have an appointment with one of our doctors.
If you need to cancel this appointment, please give us 3-day notice. Canceling with less notice will subject you to an appointment change fee of $75. This must be paid before a change in this appointment can be made. We schedule 60 minutes for this appointment and last-minute cancellation keeps us from serving others who are waiting to see your doctor.
We kindly ask that you do not cancel this appointment without appropriate notice.
It is very important that you fill out and bring these forms with you. There is a fair amount of information needed and it may take a while to fill out all this information. If you have any other information about past evaluations, please bring a copy for the doctor.
The charge for the initial evaluation is $510. This includes an office charge of $50 which is not billable to your insurance. It is required in addition to your copay if you have one. A credit card on file is required for all new patients.
Please be sure that the physician you are seeing is a provider for your insurance. We do not guarantee coverage if your insurance considers the physician out of network. A credit card is required to guarantee payment and will be needed on your first visit. We are unable to see you without a credit card on file. We also charge an administrative fee of $50 once per year.
For child evaluation, please ask a teacher who knows your child best to fill out the Teacher questionnaire in your packet. The teacher can either give the form back to you or mail it to us directly. If your child is young, please bring a game, toy or books. A caretaker while parents are talking to the doctor may also be appropriate.
Said A. Ibrahimi, M.D.