Electronic Intake Paperwork

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Office Hours

Our Regular Schedule

Monday

8am

5pm

Tuesday

8am

5pm

Wednesday

8am

5pm

Thursday

8am

5pm

Friday

8am

3pm

Saturday

Closed

Closed

Sunday

Closed

Closed

Monday
8am 5pm
Tuesday
8am 5pm
Wednesday
8am 5pm
Thursday
8am 5pm
Friday
8am 3pm
Saturday
Closed Closed
Sunday
Closed Closed