Are You A New Patient? Download Our New Patient Paperwork Here.
The New Patient paperwork and related questionnaires are available below. If you would like to complete the forms ahead of your appointment, please click on the name of the document you want to download and save it to your computer (requires Adobe Reader).
Our New Patient paperwork is saved as a PDF form; it can be filled in on your computer. You can either email back your forms or bring a hard copy to your evaluation. However, our office does provide these documents when we confirm your evaluation.
If you are unable to complete the paperwork before your evaluation, please arrive 20-30 minutes early to fill out the forms here.
What to Bring to Your First Visit:
- New Patient paperwork
- Driver’s license / photo ID
- Insurance cards
- Referral from medical provider
- Recent test results (CT, MRI, VNG)
- Medication list*
*Medication list should include dosages and frequency of prescribed and over-the-counter medications, as well as vitamins and supplements.
We are Medicare providers and accept PPO plans with out-of-network benefits. We offer a discounted private pay rate to those without insurance coverage.
Please call if you would like our office manager to verify your insurance coverage.
Patient payments for deductibles, co-insurance, and supplies are collected at each visit.
Cancellations & No Shows
We have a 24 hour cancellation policy. If you do not provide adequate notice, we are unable to fill the appointment, which is a loss for us and for someone else waiting to come in. Please call ASAP to cancel or reschedule.
Vortex charges $75 for late cancellations; $100 for no shows. These fees are collected from the patient at the next scheduled appointment. Your insurance does not pay for missed appointments.
Need to cancel? Call Vortex now.
For your convenience, our New Patient paperwork is available to download (PDF). Please download and complete the forms in advance of your first appointment.