Patient Resources

Access patient forms, insurance details, office policies, and everything you need for your visit.

Becoming a New Patient

We’re currently accepting new patients and look forward to meeting you. Here’s how to get started:

Make an Appointment

Call us at (410) 936-5500

Download Required Forms

If you prefer, you can print and bring
the completed forms to your appointment.

Arrive 20 minutes early and bring ⬇️

Insurance card, valid photo ID, list of current medications, and co-pay

Tip: Can’t print your forms? Don’t worry! We’ll have copies ready when you arrive.

Patient Forms

Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.

Authorization for Release of Medical Information (PDF)

Allows disclosure of health information to a designated individual, company, agency, or facility.

Authorization and Consent for Treatment (PDF)

Consent for treatment, communication, and financial responsibility.

Preferred Contacts (PDF)

Optional but encouraged – lets us know your preferred contacts.

Virtual Visit Policy (PDF)

Policy describing documentation, maintenance, and transmission of virtual visit information.

Office Policies

Financial Policy (PDF)

Allows disclosure of health information to a designated individual, company, agency, or facility.

Notice of Privacy Practices (PDF)

Explains how your health info may be used, disclosed, and accessed.

HIPAA Privacy Notice

Link to detailed HIPAA notice on external site

Insurance & Fees

The following is the list of insurances with which we participate. This will be updated from time to time as needed. Please verify participation prior to your visit.

Bright Health
CareFirst BCBS
CareFirst Community Health Plan MD
Cigna Healthcare
ClaimDoc
Department of Labor
Flume Health – SavATree
Humana
Humana Military Tricare
Lifeworks Advantage
Maryland Physicians Care
MDPCP MCR MD
Medicaid Maryland *verify participation
Medicare – MD
Medicare – Novitas – DC/Surr. Counties
Medicare – Palmetto GBA – VA
Multiplan/PHCS
Piedmont Community Health Plan
Priority Partners / John Hopkins
Railroad Medicare MD
Sentara/Optima
United Healthcare
United Healthcare Community Plan MD
WebTPA Custom Ink

*Medicaid participation is optional and varies amongst providers — please verify participation prior to your visit. Note: This is not an exhaustive list; plans change frequently.

Payment Options

We accept: Credit Card or Check ONLY.
No Payment Plans!
No Insurance? No problem – 50% off of your bill.

Card-on-File

We encourage patients to keep a credit card on file for faster checkout.
At check-in we will scan the card you provide (FSA/HSA accepted).
After insurance pays, we will notify you via email of any balance owed, charge the card on file, and email a receipt.
Your card data is securely processed by our partner (PCI-DSS compliant).

Fees

Category	Charge
Missed Appointment (No Show)	$50
Missed Physical	$100
Late Cancellation	$50

Out-of-Network

New Patients: Total charge or minimum $200 deposit. Established Patients: Total charge or minimum $150 deposit.

Self-Pay

New Patients: Total charge or minimum $200 deposit. Established Patients: Total charge or minimum $150 deposit. Procedures: Total charge or minimum $200 deposit.