cancelation, co-pay, vaccine, self pay, form
Designed by: TLT Engineering

Atlantic Women's Medical Group (AWMG)
CANCELLATION/ NO SHOW POLICY

APPOINTMENTS MUST BE CANCELLED AT LEAST 24 HOURS IN ADVANCE.  IF YOUR APPOINTMENT IS NOT KEPT OR CANCELLED, A FEE WILL BE CHARGED.  YOU MAY BE ASKED TO RESCHEDULE YOUR APPOINTMENT IF YOU ARE MORE THAN 30 MINUTES LATE.

CO-PAY POLICY

ALL CO-PAYMENTS ARE DUE AT TIME OF SERVICE.  WE ACCEPT CASH, CHECK, CREDIT CARDS, AND DEBIT CARDS.  PLEASE CHECK IN WITH RECEPTIONIST UPON ARRIVAL AND GIVE PROPER INSURANCE INFORMATION AND CO-PAYMENT.  IF YOU DO NOT HAVE YOUR CO-PAYMENT YOU WILL BE ASKED TO RESCHEDULE YOUR APPOINTMENT.  IF THERE IS A DELAY IN PAYMENT DUE TO WRONG INSURANCE INFORMATION, THEN YOU WILL BE RESPONSIBLE FOR FULL PAYMENT.  ALSO, YOU WILL BE RESPONSIBLE FOR SUBMITTING TO YOUR INSURANCE COMPANY ON YOUR OWN.


OFFICE VACCINE POLICY

THE HPV AND HEP A/B VACCINE IS GIVEN IN A SERIES OF THREE INJECTIONS.
YOU WILL RECEIVE THE FIRST INJECTION, TWO MONTHS LATER RECEIVE THE
SECOND, AND FOUR MONTHS LATER RECEIVE YOUR THIRD (FINAL) INJECTION.
IF ANY OF YOUR INJECTIONS ARE LATER THAN EXPECTED, YOU HAVE UP TO ONE YEAR TO HAVE ALL THREE INJECTIONS ADMINISTERED.

IF YOU ARE INTERESTED IN GETTING THE HPV OR HEP A/B VACCINE PLEASE CALL KATHY AT 732-229-1288 EXT 20. KATHY WILL HELP WITH VACCINE AVAILABILITY AND BEST TIMES TO COME IN FOR THE INJECTION.

ALSO, YOU ARE EXPECTED TO WAIT 15 MINS. AFTERWARDS TO MONITOR ANY POSSIBLE SIDE EFFECTS.

PREPARATION FOR BONE DENSITY TESTING:

1.)DO NOT TAKE ANY CALCIUM SUPPLEMENTS THE DAY OF YOUR APPOINTMENT.

2.)WEAR LOOSE FITTING CLOTHING WITH NO METAL-ZIPPERS, BUTTONS, BRAS WITH UNDERWIRES, ETC- OTHERWISE YOU WILL NEED TO CHANGE INTO A GOWN.
SELF PAY FORM
AWMG notice of privacy practices