New Patient Registration Forms for Michiana Internal Medicine, PC

Your visit:

Please download Registration forms from our website, fill out completely and bring items that apply to you:

  • Registration form
  • Insurance card
  • Driver’s license
  • A family member or friend that you wish to be informed about your condition.

Insurance:

We accept most insurances including Medicaid and Medicare. We will bill your insurance out of courtesy to you. It’s your responsibility to make sure you are covered for your visit. Co-payments are expected to be paid at the time of your visit. We accept cash, checks and credit cards.

Billing and fee:

Our fees are customary and competitive with those charged by other Internal Medicine practices in our area. For billing questions, please call our billing company Curemd at (732) 347-1317.

Phone call:

When you call and request to speak with a physician or nurse, we will do our best to return your call same day or next day. As a policy, we do not interrupt regular office care with non- emergency phone calls.

Emergency situations:

In case of an emergency, please dial 911 or go to nearest emergency department.

After hours:

In case you have a question or situation after office is closed, please call our answering service at (866) 895-6707. A physician on call will return your call promptly.

Cancellations:

We require 24 hours notice of any cancellations. If you cancel an appointment within 24 hours, it will be considered a no show and may incur a fine or dismissal from the practice.