New Patient Registration Form
Complete this form before your appointment and bring it with you when you arrive.
Download PDFAccepting new patients! Follow the steps below to see us.
Four simple steps
Call us at (513) 860-4600 and we will look up your coverage with you, or check directly with your insurance provider to confirm we are in your plan. Have your member ID ready either way.
Call (513) 860-4600 and press #2 to reach the front desk. New patient appointments are booked by phone rather than online so we can match you with a provider and answer questions while you are on the call. Our office hours are Monday–Friday, 7:30 AM – 4:30 PM.
Download the New Patient Registration Form (PDF), fill it in before your appointment, and bring it with you. Completing it in advance means your first visit can start on time.
Arrive 15 minutes before your appointment time at 4870 Wunnenberg Way, West Chester, OH 45069, so there is time to finish any remaining paperwork. Bring your completed registration form, photo ID, insurance card, and a list of the medications you currently take.
Before your visit
Complete this form before your appointment and bring it with you when you arrive.
Download PDFAnnual update forms for our established patients.
Download PDFIf you have a question about your bill please call our billing company at 607-760-1326. Bev will be happy to help you.
Please call our front desk at (513) 860-4600, press #2, and our receptionists will be happy to get you scheduled for your new patient appointment.