Welcome to our office. Phone: 410.321.1195
Office hours: Mon - Fri 7:00 AM - 4:00 PM
(phone hours: 8:00 AM - 4:30 PM)
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.
Please complete these forms early! You may email them to us at: Front@drmarklowitt.com
Telemedicine Consent Form
IMPORTANT:
1) You must complete the registration 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.
FOR ALL PATIENTS WHO MUST COMPLETE PAPERWORK (New patients and those not seen in 3 years): PLEASE ARRIVE 15 MINUTES BEFORE YOUR APPOINTMENT TIME WITH YOUR COMPLETED PAPERWORK. IF YOUR FORMS ARE NOT COMPLETED IN ADVANCE WE CANNOT GUARANTEE THAT YOU WILL BE SEEN.
If you arrive 15 minutes after your scheduled time, OR if you arrive at your appointment time but your paperwork has not been complete, your appointment will need to 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 List of insurance companies we participate with
MISSED APPOINTMENT POLICY
Please notify us as soon as possible if you are unable to keep your appointment. We reserve the right to charge a fee of $50.00 for missed appointments (“no shows”) and appointments which, absent a compelling reason, are not cancelled with a 24-hour advance notice. A fee of $100.00 will be charged for missed surgical appointments.
Patients who miss three appointments without notifying us within 24 hours will be discharged from the practice.
Driving Directions
|