Patient Guide

Appointment/Procedure Preparation

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

Cancellation Policy

All visits and treatment sessions are by appointment only.  We recommend that you arrive at least 15 minutes prior to your scheduled appointment time. If it is necessary to cancel, we request that you call at least 24 hours or one (1) business day in advance of your scheduled appointment. Same-day appointments are in high demand and, as a courtesy to us and other patients needing medical attention, an early cancellation notice is necessary and much appreciated.

Late cancellations will be considered as a “no show”.

No Show Policy

A missed appointment, or "no-show," occurs when a patient fails to give the above notice that the appointment cannot be kept. Since the appointment has been set aside especially for you, that time cannot be used to treat others.  Thus, our policy is as follows:

• After your third missed appointment, you will be charged a $25.00 “no show” fee that is not covered by your insurance.
• Please let us know if there was an emergency that prevented you from keeping your appointment as it can be taken into consideration by your physician.

Reminder:  A fourth (4) missed appointment may result in your dismissal from the practice.

We appreciate your understanding of the importance of this matter.

Prescription Refills

(937) 208-2544(937) 208-2544

When you call for a prescription refill, please give us the following information:

• Please spell your name
• Please spell the name of the medication
• Please provide your date of birth

What to Expect

Please bring your health insurance card, picture ID, and list of your current medications or prescription bottles with you to your appointment.

If you have a co-pay, please be prepared to make payment at the time of service.

After Your Visit or Procedure

You will receive follow-up instructions and notification of test/lab results by phone or mail.

Billing and Insurance

Find a list of the major insurance plans accepted by most Premier Physician Network offices here. Family Medicine of Huber Heights accepts most of these insurance plans.

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.