LutzTampaWesley Chapel
Patients
Forms & Policies.
Everything in one place — patient and consent forms, billing, insurance and office policies, self-pay rates and our website terms.
Patient Forms
New patient packets, release and consent forms, plus downloadable documents.
OpenConsent Forms
Ear piercing, flu vaccine, HIV and pregnancy testing, medical and waiver consent.
OpenBilling and Payment Policy
What to expect for copays, deductibles, claims and insurance changes.
OpenOffice Insurance Policies
Eligibility, newborn coverage, no-show fees and the updated 2024 payment policy.
OpenOffice Policies, Statements & Guidelines
Office policies, statements and documents you need to be aware of and acknowledge.
OpenSelf Pay Rates
Know your costs before treatment.
OpenInsurances We Accept
We accept most insurance plans — see the full list.
OpenTerms & Conditions
The terms, conditions and notices for use of this website.
Open