PATIENT FORMS

Young successful businessman looking forward into the future

Young successful businessman looking forward into the future

To make your visit as timely as possible for you on your first infusion visit, we provide the following forms for you to print, complete, and bring with you to your first appointment.

If you have any questions about the forms or about what occurs on your first visit, you may contact us at (614) 430-8022

Patient Demographics (pdf)

Insurance Information (pdf)

Insurance Consent and Appointment Policy (pdf)

Optimed Privacy Notice (pdf)

Optimed Patient Financial Policy (pdf)