Welcome to our office. Phone: 410.321.1195
Office hours: Mon - Fri 7:30 AM - 4:30 PM Selected Saturdays 8:15 AM - 11:45 AM
Registration Forms If you have scheduled an appointment, please download and print our registration materials by clicking the appropriate link below.
New Patient (Adult) New Patient (Minor) Medicare Patient
If you are unable to print the forms, please call us. We will be happy to mail copies to you.
IMPORTANT:
1) You must complete these forms before you arrive.
2) All patients who are new to the practice AND those not seen in the past three years must complete these forms.
3) IF YOUR FORMS ARE NOT COMPLETED IN ADVANCE WE CANNOT GUARANTEE THAT YOU WILL BE SEEN.
If you arrive 20 minutes after your scheduled time, your appointment will be rescheduled.
If your insurance requires a written referral, the referral must be here in the office by the time of your appointment.
Please be sure to bring the following with you to every appointment: Referral if required Co-pay as dictated by your insurance plan Current Insurance Card Photo ID
Is the Patient a Minor?
Patients under the age of 18 MUST be accompanied by a parent or legal guardian ON EVERY VISIT. Minor patients that arrive unaccompanied cannot be seen and will need to reschedule when a parent is available. A parent may complete a release form allowing the child to be seen alone or with a designee.
Insurance Download: List of insurance companies we participate with
A special note about United HealthCare:
Dr. Lowitt does not participate in the United HealthCare network. Should you elect to receive your care with us, as a courtesy to you, our billing department will submit your claim to United. United would consider the service to be an "Out of Network Visit." We therefore advise you to contact your insurance provider 1) to make sure that your policy includes Out of Network coverage and 2) to see exactly what that coverage entails. Many policies will assign a greater financial responsibility to the patient should he or she choose an Out of Network provider. If you do elect to be seen here, we will require a signed waiver from you, indicating that you understand that you may be responsible for the portion of the bill that United does not cover.
MISSED APPOINTMENT POLICY
If you are unable to keep your appointment, please notify us immediately.
Patients who miss three appointments without notifying us within 24 hours will be discharged from the practice.
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