Patient Guide

Appointment/Procedure Preparation

To schedule an appointment, please call (937) 773-3737(937) 773-3737.

We ask new patients to arrive 15 minutes prior to their initial appointment to complete any of the necessary forms from the list below: 

• Patient Registration Form - Adult
• Patient Registration Form - Minor
• Patient History Form
• Medical Release Form
• Verbal Communications Form
• Advance Directives Patient Education Form
• Advance Directives - Health Care Power of Attorney and Living Will

What to Expect

Please be sure to bring either your medications or a list of the medications you are currently taking along with your insurance card(s). You may be asked to complete a new Patient Registration Form during your first visit of each year.

All patients should come prepared to pay any co-pays, deductibles or co-insurances at the time of their visit.

Upper Valley Internal Medicine practices outpatient medicine. Should you require hospitalization, we will refer you to our specialists who will care for you during your hospital stay. After you are released from the hospital, we can easily coordinate any follow-up care needed with these specialists.

After Your Visit or Procedure

Your provider may wish to schedule a follow-up visit. Our staff can schedule any tests or procedures that need to be performed outside of our office, or give you the information to schedule the appointments on your own.

Billing and Insurance

Premier Physician Network’s customer service team is happy to answer any questions about billing and insurance you may have. Find detailed billing and insurance information in the Premier Physician Network billing section.