Please note the following forms are for Dr. David Gordon’s medical practice.  These forms and policies do not apply to the practice of Dr. David Amli.  For Dr. Amli’s forms, please click here.

Policies

• Office Policies

• Financial Policies 2012

• Notification of Privacy Practices

          

• Identify Theft Prevention Policy

Forms

• Credit Card Authorization Form for Paying 2012 NCBF Monthly

          

• Consent to Treatment Form 2012

          

• Patient Registration Form

          

• Release of Information to Transfer Care from Dr. Gordon to Another Physician

          

• Release of Information to Send Records to Dr. Gordon from Another Physician

          

• Release of Information – Generic Form

            

General Information

• Fee Schedule

          

• Insurances Accepted

          

• Recommended Urgent Care Locations
  

          

• Quest Diagnostics Locations

          

• Labcorp Locations

          

• Physicians Accepting New Patients
  

• Physicians Accepting New Medicare Patients
  

• Female Physicians Accepting New Patients