Welcome!

Welcome to Our Practice!

We’re delighted to welcome you as a new patient. Your initial rheumatologic comprehensive evaluation will take approximately 1 to 1.5 hours. To help us provide you with the most thorough and personalized care, please download and complete the health questionnaire before your first visit.

Bringing this completed form will allow us to focus more of your appointment on your current concerns and symptoms. We also kindly ask that you bring any recent imaging studies-such as X-rays, MRIs, bone density scans-and lab results related to your condition.

We look forward to partnering with you on your path to better health.

New Patients

Please print the following forms and fill out prior to your first appointment.

Medical History

Credit Card on File Consent

Credit Card on File Policy

As you are aware, healthcare has seen some dramatic changes in the past few years. High-deductible health plans are now a mainstay of the healthcare landscape. This means that more of the responsibility is being placed on patients. We need to be sure that patient balances are paid in a timely manner. If you have ever stayed in a hotel or rented a car, you are familiar with the concept of having a credit card on file. Your credit card information is stored in a secure, encrypted manner and only accessed and charged if there is an outstanding balance due. As of June 2023, Rheumatology Associates has adopted a Credit Card on File policy. At the time of registration, we will request your credit card information. Your credit card numbers will be encrypted and stored securely. Once we receive your Explanation of Benefits (EOB) for your insurance company, we will wait 30 days to allow you time to pay the balance on your account. If your balance is not paid, your credit card will be charged for the outstanding balance that is your responsibility. Co-pays must be paid at the time of your visit. All your rights with respect to use of your credit card will remain in effect. This new policy will in no way prevent your from being able to dispute a charge or question your insurance company’s determination of payment. If you have any questions about this payment method, please do not hesitate to contact our billing department at: 772-283-8380 option 4.

Name

First Name

Last Name

I authorize Rheumatology Associates PA to charge the credit card provided per the terms of this policy. This authorization shall remain in effect until I provide written notice of its termination.

Authorization and Consent

I consent

Credit Card Information

Type

Card Number

Please enter your card number here:

Expiration month

Month

Expiration Year

CVV

Enter CVV

How to schedule an appointment

Call (772) 283-8380 press option 2.

If you need to cancel an appointment, please give at least 24 hours notice (48 hours for new patient appointments) so that we may offer that time to another patient. Or request your appointment through the Patient Portal.

How to refill medications

Medications are prescribed electronically (e-prescribe). If you need a refill between appointments please ask your pharmacist to initiate an electronic refill request. You also may leave a refill request on the prescription line voicemail. Allow at least 48 hours for processing of refill requests. A refill request may trigger a call for you to schedule an appropriate office visit for management of your condition and monitoring of your medications. Controlled medications require an office visit every 3 months (state law). Controlled medications will not be refilled after hours or during weekends.

Records Release

Records Release Form

Good Faith Estimate

CMS Notice

Pricing Disclosure

Insurances

Our office participates with the following insurance plans:

Traditional Medicare
Devoted Health Plan
Cigna
FL Blue
Aetna
Partner’s Direct (coming 9/1/2025)
Participation varies as changes occur within the insurance industry. We encourage you to confirm your specific coverage before scheduling an appointment.

Mutual Respect

We are dedicated to the safety of every patient, visitor, and caregiver. We will not tolerate any form of threatening or aggressive behavior toward our caregiver team.

Examples include acts or threats of:

Physical violence
Harassment
Intimidation
Abusive or foul language
Other aggressive, disruptive behaviors

Notice of Privacy Practices

Privacy Practices-English

Privacy Practices-Espanol