Located directly off of I-675 :: 7076 Corporate Way :: Centerville, OH 45459 :: 937.434.0555 :: Fax 937.434.7413
Hours: M 8:45 - 5:45 :: T 9:15 - 5:00 :: W 8:45 - Noon :: Th 8:45 - 5:00 :: F 8:45 - 5:00 :: Sa 8:45 - Noon
Forms
Please print, review and complete this packet of forms and bring them to your first visit. The packet contains the following forms and information:
- Financial Information
- Medical History
- Patient Authorization of Disclosures
- Consent to the Use and Disclosure of Health Information
- Financial and Payment Policy
- Insurance Coverage Information
- Privacy Policy
- Cologne and perfume advisory
- Directions to the office