I agree to abide by the following while I am under the medical care of Sunshine Medical Center:
To keep the office informed of any changes in my address, phone numbers and insurance information, by calling with the new information or giving it to the front desk upon signing in.
Patents under 18 must have a parent or guardian sign an authorization to be treated at each visit. For school age patients, a copy of their immunization record is to be given to the office.
Whenever possible, contact the office for prescription renewals 7-10 days before medication runs out, and to call ahead before picking up written prescriptions.
If for any reason you cannot make your scheduled appointment, please call our office 24 hours prior to cancelling your appointment otherwise you will be billed $25.00 for a missed appointment.
For urgent medical care after hours or on weekends, call the office and leave a voice mail message including your name and phone number. The doctor will return your call promptly, so have your pharmacy phone number handy. For a true medical emergency, call 911 to be taken to Sarasota Memorial or Doctors Hospital emergency room and inform the ER of your doctor's name. The doctor will follow your hospital treatment.
If you need to change doctors, the office has a written request form which must be completed. Your medical records will be copied and you may pick them up when ready or records may be faxed or mailed to the doctor whose name and address you have supplied to us. A charge may be applied.
Medicare assignment of benefits is accepted. Regarding other insurance coverage, please check with the office. Be advised that deductibles and co-payments are your responsibility and are due at the time of service. Other (non-insurance) payment is due at the time of service.
I have read and agree to abide by the policies written above.