New Patient Forms & Policies
We ask that you please print and review the following new patient forms to the right, prior to your initial office visit. It is crucial that we receive all completed forms (New Patient Intake, HIPPA, Informed Consent and Office Guidelines) before you are seen by Dr. Marra, as it will enable us to provide proper assessment and health care for your needs. We ask that you please arrive 15 – 20 minutes early with your completed forms at your first appointment. For children under 18 years of age, we will need to have guardians sign and date all forms where applicable.
Forms & Policies 2 - Daisies Orange
Insurance
We do not accept insurance, however the office does provide you with an insurance compliant superbill that you can submit yourself. Generally, most insurance companies will reimburse you some amount for your office visit, depending on your insurance carrier and your policy. Please contact your insurance carrier directly for details.
New Patient Initial Appointment
There is a deposit of $200 to schedule a new patient appointment with Dr. Marra. These appointments may last from 1 - 1.5 hours. If you need to reschedule or cancel your new patient appointment, please give the office at least 3 business days before the scheduled visit. For example, if your appointment is on a Monday, you will need to cancel or reschedule the week before on Tuesday (we are closed on Wednesdays & Weekends) to receive a refund on your deposit.
Appointments
To enable us to provide efficient care, we ask for your cooperation in regards to arriving at, or just before your appointment time. If you arrive late for your appointment without notice, we reserve the right to reschedule the appointment. Late arrivals will cause a delay in seeing patients who are on time. If you are running late, we recommend that you call our office to determine if we can hold your appointment. Please respect Dr. Marra's and other patient's time, as we will always respect yours. All appointments will receive a reminder at least one day before from the office.
Cancellation Fee
Please be mindful when rescheduling or cancelling your appointment. We require at least 48 hours (2 business days) notice to cancel or reschedule your appointment, otherwise a $200 fee will incur. For example, if your appointment is on a Friday, you will need to notify the office on Monday earlier in the week. Please keep in mind that the office is closed on Wednesdays and weekends. There is no charge for appointments canceled or rescheduled within the appropriate amount of time. $200 will be charged if you decide not to show up, cancel or reschedule without proper notice. Insurance will not cover this fee as it is the patient's responsibility to maintain appropriate office visits.
Phone Consults and Skype Appointments
Phone consults and Skype appointments are provided for established patients that have been seen at least once before by Dr. Marra. These appointments will be assessed on a case by case basis before they can be made. If you have a phone consult or Skype appointment with Dr. Marra, please be sure to call into the office or request the Skype video call with Dr. Marra at your scheduled time. All appointments will receive a reminder at least one day before from the office.
Test Results
Please do not call the office requesting test results. Test results will not be given to you over the phone, or mailed to you before they are reviewed with Dr. Marra. Please make an appointment with the office to review your test results. Thank you for your understanding.
Emergency Contact
Dr. Marra's personal line is for medical emergencies only during non-office hours. Please be respectful when contacting Dr. Marra's personal line, as a fee will incur for all emergency phone consults. All other non-emergent medical and administrative contact can be made by calling into the office. We appreciate your cooperation.
Payment Terms
We accept payment by Cash, Check, Visa, Mastercard and Debit. The patient is responsible to pay any billed amount by Dr. Susan L. Marra during their visit. Failure to pay any outstanding amount upon receipt of a third and final statement will subject the account to be forwarded to a collection agency, with any additional fees charged by the collection agency added to the original amount owed. It is understood, and agreed that in the event that an overdue balance is referred to a collections agency or attorney for recovery of fees, the patient is fully responsible for any and all costs incurred, including, but not limited to, attorney fees.
Forms & Policies 3 - Lavendar bunchMailing/Shipping Terms/Refunds EcoMedica will mail items purchased and paid in full plus postage. Patients are responsible during their appointments to discuss their treatment plan and supplement needs accordingly with Dr. Marra. Unfortunately we cannot be responsible for your reception of items shipped to you. We do not refund or replace damaged or missing items.
We do provide refunds within 30 days of purchase date with original sales receipt. There will also be a 15% re-stocking fee and item(s) cannot be damaged, opened or altered in any way. We do not refund or exchange item(s) that we no longer carry.
If you have any questions regarding the forms and policies, please contact the office at (206) 299-2676. We ask that you please do not disclose your personal medical information by e-mail or facebook as it is against HIPPA regulations. Thank you for your understanding.