Patient Forms
What to Bring to the Appointment
To ensure a smooth and efficient visit, please bring the following items to your appointment:
- Government-Issued Photo ID (e.g., Driver’s License, Passport)
- Insurance Card and Pharmacy Benefit Card
- Physician Referral Authorization (if required by your insurance)
- List of Medications – Include all current prescriptions and over-the-counter medications with strength, dose, and frequency
- Recent Medical Reports – Bring recent lab results, MRIs, CT scans, and X-rays
- Medical Power of Attorney (if applicable)
- Completed Patient Information Packet
Important Note:
If you are unable to complete your paperwork before your visit, please arrive 30-45 minutes early to complete the necessary forms.
Opening Hours
Our office hours are as follows:
Monday – Thursday 8:00 a.m. – 4:00 p.m.
Our office is closed for lunch between noon and 1pm. (Friday 8:00 a.m. – 12:00 p.m.)
Patient Forms
You can complete our forms online and print prior to your appointment. These are PDF fillable forms that require Adobe Reader to open them.
(All Medical Records Release forms need to sent to HealthMark Group and you can contact them at +1-800-659-4035 )
Insurance and Payment Information
We accept most major insurance plans, including Medicare. Dr. Rosen-Schmidt are not accepting any NEW Medicare patients. We do not accept Medicaid or Medicare/Medicaid replacement plans. We also do not see any patients that have been involved in motor vehicle accidents, work related incidents or if you have an open lawsuit regarding an injury or illness unless your medical issue is completely unrelated to any of these items listed.
(Please note that we are a Fragrance Free office as perfumes, colognes, body sprays etc. can be harmful to some of our patients. You may be asked to wash these off prior to being seen.)
