Get New Patient Forms - Savannah Cardiology

Filling out the New Patient Forms for Savannah Cardiology online is an essential process for ensuring your information is accurately recorded. This guide will walk you through each section of the form, providing clear instructions and helpful tips to make it easier for you.

Follow the steps to successfully complete the New Patient Forms.

1. Press the ‘Get Form’ button to access the New Patient Forms. This will allow you to open the form in an editable format.
2. Begin with entering your sex by selecting 'Male' or 'Female'. This information helps in identifying your gender for the medical record.
3. Fill in your full legal name as it appears on your official identification documents. Accurate names are critical for medical records.
4. Provide your complete residence address, including city, state, and zip code. This information is necessary for communications and billing purposes.
5. Enter your home phone number in the specified format. This number will be used for appointment reminders and important communications.
6. State your date of birth (DOB) to confirm your age, which can be relevant for treatment considerations.
7. Input your Social Security Number (SSN) for identification purposes. Ensure this is correct to avoid potential issues with billing or insurance.
8. Indicate your marital status by selecting from the options provided: Married, Single, Divorced, or Widowed. This information can be relevant for the interpersonal context of care.
9. If applicable, fill in your spouse's name and date of birth, along with their Social Security Number and employer details.
10. Answer whether you have ever been a patient at this practice. If yes, include the year of your last visit for references.
11. Provide your email address for electronic communications regarding appointments and medical information.
12. In the insurance information section, confirm whether you have Medicare or Medicaid. If yes, input the corresponding numbers and specifics.
13. List your health insurance company's name, address, and contact number. This is essential for billing and communication purposes.
14. Fill in your policy number and the policyholder's name along with their relationship to you. This verifies coverage under the plan.
15. Choose the type of insurance plan you have: HMO, PPO, or Other. Understanding the plan type helps in determining referral processes.
16. List the names, addresses, phone numbers, and relationships of two people not living with you to contact in case of an emergency.
17. Once all sections are completed, you can save changes to the form. You may also download, print, or share the completed form as needed.

Complete your New Patient Forms online today for a seamless entry into your healthcare journey.