|
REGISTRATION
FORMS
Please print and fill-out your registration
forms prior to your appointment.
WE ARE LOCATED
200 Butler Street
Suite 303
West Palm Beach, FL 33407 | map
Office (561) 837-9880
Fax (561) 837-9884
info@kotzencenter.com
|
Welcome to our office!
We are so pleased you made the decision to join other
health-conscious women who want personalized and exceptional
medical care—women like yourself who want the most
advanced medical services, knowledge and technological
tools available to maintain optimal health.
It is important to complete the Confidential
Patient Information Form before your appointment.
We need your medical history to ensure you receive the
most personalized medical treatment available. Please
bring the completed forms to your appointment. And please
be aware that Dr. Kotzen, like most physicians, cannot
assume responsibility for your medical care or treatment
until you have your medical exam.
Please note that all your information is confidential.
That means your medical history and current information
will not be discussed with anyone, including your relatives,
other doctors and/or insurance companies, without your
specific expressed permission.
Our office staff is happy to answer any questions about
billings, methods of payment and/or appointment availability.
To ensure you understand our service payment guidelines,
please note that our office:
- Does not participate in any HMO insurance plans.
- Does not participate in PPO or other insurance
plans but we will complete and file your claim
form(s) upon request. Any reimbursements will be sent
to the patient.
- Does accept assignments for Medicare patients.
- Accepts American Express, Discover and Visa/MasterCard.
- Payment is due at the time services are rendered.
Again, we appreciate your decision to choose Dr. Kotzen
for your medical and preventative health care needs.
Our goal is to provide you with the most conscientious
and caring medical services possible, in a relaxed and
warm atmosphere. Please know that we are here and available
for your special requests or needs.
Most of all, we look forward to meeting you in our
office.
|
