First Visit Paperwork

Prior to your initial appointment, please print and fill out the forms at the bottom of this page, including signing the Consent/HIPAA form and, if necessary, the Medicare form.

Wear loose, comfortable clothing – please no skirts or tight jeans. You will remain clothed throughout, just removing shoes, belt, watch and any items from your pockets. Please refrain from wearing scented products and perfumes as many of our patients have sensitivities.

The initial appointment will be one hour. After reviewing your medical history, we will perform a general medical exam as necessary followed by an Osteopathic structural exam and treatment. Follow-up visits are 30 minutes. At the disrcretion of the physican, newborns may be seen as follow-ups for mothers who were seen during pregnancy and/or after delivery.

Policies:

  • Unfortunately, we do not accept Worker’s Comp or HMOs (including Kaiser). Drs. Blackman and Shadoan only see Medicare patients independently of Medicare coverage. You will not be reimbursed by Medicare or MediGap plans. Dr. Gilmartin is unable see Medicare patients at this time.
  • You will receive a bill to mail to your insurance, but we do not bill insurance directly. Reimbursement is likely only from auto insurance (possibly up to 100%) or some PPO policies (20-60% once deductible has been met).
  • Please, cash or check only, except for patients of Dr. Shadoan who does accept credit and debit cards.
  • We require one full business day notice for cancellations, otherwise the usual fee will be charged. (24 hours except for Monday appointments, which must be cancelled by Friday morning.)
  • As a courtesy, we will call 1-2 days in advance of upcoming appointments. If you do not receive a call, please call us to confirm that you are in our books.
  • For your first appointment, please confirm with us a few days prior to the appointment. If we do not hear from you, we will have to cancel it.

Click Links for Forms:

Please Read Our Privacy Practices Here

Initial Visit Forms:  Adults age 18 or older and Babies and Children under age 18

Form for Motor Vehicle Accident Cases

Medicare Agreement for all Medicare Patients (for Drs. Blackman and Shadoan only, Dr. Gilmartin is not able to see Medicare patients at this time)

 

If you have any problems, please call the office and we will fax or email the documents. You may also arrive to your first appointment 15-20 minutes early to fill the paperwork out in our office.

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1956 Union Street at Buchanan, San Francisco, CA 94123 • 415-921-1446 • info@do-sf.com