patient

Please bring ID and your insurance card with you to all appointments. We will submit your claims to your insurance company. You will then be billed for any amount not covered by your policy.

Want to be proactive with your patient documentation?
Want to reduce paperwork and time at the doctor's office?
It's simple. Here's How!

	1:	We provide digital forms on our web site for the patient to print directly from their home computer.
	2:	Fill out the forms at your convenience.
	3:	Bring your completed patients forms in at the time of your appointment.

Patient Forms:

• Patient History Form
• Patient Registration Form
• Patient Financial Agreement
• Phone Release Form
• DEXA Patient History
• Work Release Form
• HIPPA Document


COPYRIGHT © 2007. All content (elements) on this web site are the expressed property of Arthritis Care Center P.C. and for the purpose of educating the public on the affects of Arthritis, Rheumatology, Osteoporosis. No replication of any type for any purpose is permitted.


	Usharani M Kumar M.D. Rheumatologist Conveniently located in Wildwood Office Park 609 35th Avenue • Moline, IL 61265 • Office: (309) 762-4500 Fax: (309) 762-4661