DOYLESTOWN THYROID & ENDOCRINE ASSOCIATES, LLC

103 Progress Drive, Suite 300

Doylestown, PA 18901

(215) 447-3630


Dear Patient,


Welcome to our practice!

Please bring with you the following items:

  • A VALID REFERRAL: Please remember to contact your primary care physician and request a referral if required by your insurance. You will NOT be seen without it. We will assist you in rescheduling your appointment if you have no referral.
  • COMPLETED demographics and new patient forms. If you are a new patient of the practice or have not been seen in over 3 years, it is necessary to complete these forms. Your doctor will need to enter your history into our new electronic health record.
  • PROOF OF IDENTITY must be presented at each visit. Acceptable forms of ID include ONE of the following: driver’s license or other photo ID.
  • CURRENT HEALTH INSURANCE CARD
  • MEDICAL RECORDS: If you are a completely NEW PATIENT and seeing us for the first time, please bring in hand your pertinent medical records including doctor’s notes and labs/ radiology/ pathology.
  • BLOOD SUGAR LOGBOOK – for diabetic patients, it is imperative that you bring a list of your recent blood sugars.
  • CURRENT LIST OF MEDICATIONS

Please arrive 15 minutes before your scheduled appointment to complete the check-in process. We require 24 hours’ notice for cancellation. There is a $50 charge for failure to show for a new patient appointment and a $50 charge for failure to show for a follow-up visit.

**Payment is required at the time of service. This includes co-payments and self-pay fees.**

Thank you!

Doylestown Thyroid & Endocrine Associates