Patient Center
Patient Forms
For the convenience of our patients, Maxa Internal Medicine has made our most common practice forms available for download and completion by patients. Please print and complete these forms before your appointment, and bring them with you to your appointment.
- Patient Information
- Patient Medical History
- Financial Policy
- Prescription Medicine Refill Policies
- Patient Record of Disclosures
- Policy and Procedure for Chronic Pain Management
- Acknowledgement of Notice of Privacy Practices
- Additional Patient Information
Insurance
For your convenience, we participate in many managed care programs. Check with us to make sure we participate with your plan. Because plans vary greatly in levels of benefits and hospital participation, please familiarize yourself with your insurance plan and its restrictions. (We make every effort to guide you in the right direction, but ultimately it is your responsibility to stay within the guidelines of your plan.)