Form Downloads
Follow Up Visit
Forms
You must review your name, address and insurance information at the top of your encounter form for each visit to ensure accuracy. Please intial this information and inform us of any changes.
You are required to fill out a short follow-up form at each visit. This form allows Dr. Ratzman to see how you are doing and assess how treatment is progressing.
You must bring your insurance card with you to each visit. The card/cards will be reviewed to make sure we have your current insurance information to ensure correct billing and so that you do not incur any expenses due to rejection of insurance claims.
Payment
After the follow-up form is completed and returned to the front desk, your co-pay/co-insurnace is collected and you will be brought into the exam room.
Check-Out
After your visit with Dr. Ratzman, you will be scheduled for your next visit if applicable and instructed on the next steps in your treatment. Any testing or further appointments will be scheduled at this time.