**NOW OFFERING COVID-19 TRAVEL TESTING-SAME DAY RESULTS**

Call or Text: 407-777-2673

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  • Services
    • COVID-19 Testing
    • Primary Care
    • Functional Medicine
    • Alternative/Acupuncture
    • Hormone Health
    • Weight Loss Program
    • Pain Management
    • Injection Therapy
    • DOT/CMV Physicals
    • School & Sports Physicals
    • Pre-Employment Physicals
    • In Office Lab
    • Fee Schedule
    • Pharmacy/Fullscript
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    • Home
    • About Us
    • Services
      • COVID-19 Testing
      • Primary Care
      • Functional Medicine
      • Alternative/Acupuncture
      • Hormone Health
      • Weight Loss Program
      • Pain Management
      • Injection Therapy
      • DOT/CMV Physicals
      • School & Sports Physicals
      • Pre-Employment Physicals
      • In Office Lab
      • Fee Schedule
      • Pharmacy/Fullscript
      • Florida Scope of Practice
    • Patient Forms
    • Contact Us
    • Schedule Online

Call or Text: 407-777-2673

  • Home
  • About Us
  • Services
  • Patient Forms
  • Contact Us
  • Schedule Online

NEW PATIENT PAPERWORK

NEW PATIENTS: PLEASE COMPLETE THE NEW PATIENT FORMS ONLINE BY CLICKING HERE or the link below. If you are coming for COVID Testing or a DOT Physical, you do not have to complete these forms. 


 If for any reason you are not able to complete the forms prior to your appointment, please arrive 20-25 minutes early to ensure you have enough time to complete the paperwork at the office.   


In an effort to to provide excellent care to our patients, our schedule is kept on time and is strictly structured. This is so I can focus time and attention to each patient in a non-rushed manner. 


**COVID-19 TESTING PATIENTS & DOT PHYSICALS  DO NOT HAVE TO COMPLETE THIS SET OF PAPERWORK.**

NEW PATIENT PAPERWORK (NOT FOR COVID TESTING OR DOT PHYSICALS)

OTHER Patient forms

DOT/CDL Driver Form (pdf)Download
Authorization to Release/Obtain Medical Records (Medical Records Release Form) (pdf)Download
Authorization to Release Medical Information (HIPAA Authorization Form) (pdf)Download

INSURANCE INFORMATION

Acupuncture:  We require payment up front for services but we will file insurance on your behalf to check for coverage & reimbursement. Typically, only select plans pay for limited services, such as low back pain only.   


Functional Medicine/Primary Care: We remain out of network for all other services, including Functional Medicine & Primary Care at this time. Insurance companies restrict the time we are able to spend with you and  we tend to spend 45-60 minutes with new patients and 30-45 minutes with established patients.  We are happy to provide you with the necessary paperwork for you to submit to your insurance company for possible reimbursement.    


For this reason, we are able to keep our fees low and affordable for our patients. (Please see Fee Schedule).  Any lab work, imaging, prescriptions, etc that we order can be covered by your insurance. 


HSA/FSA cards are accepted and all services are eligible.  


The following plans MAY cover select acupuncture services  Please check with your plan to see if Acupuncture benefits are available.   


Aetna 

Aetna Medicare Advantage HMO 

Anthem Blue Cross Blue Shield Medicare Advantage HMO & PPO 

BayCare Plus Medicare Advantage HMO 

Cigna

Cigna Medicare Advantage HMO & PPO 

Florida Blue Medicare Advantage HMO 

Providence Health Plan EPO Network Access Plan 

Simply Health Clear Health Alliance, Medicaid, Medicare Advantage HMO 

ASH (Ascension Complete St. Vincent's, BayCare, Molina Healthcare, Oscar Health Insurance) 

United Health Care 

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Dawson Integrative Medical Center, LLC.

Located in Conway Professional Building 3203 South Conway Road Suite 204-A, Orlando, Florida 32812

Call or Text: 407-777-2673

Copyright © 2022 Dawson Integrative Medical Center, LLC. - All Rights Reserved.