If you are scheduled as a new patient for Elizabeth Markovich or Ali Craig-Rodriguez please fill out these forms:
| new_patient_packet.docx |
Once forms are printed and filled out they can be:
Faxed to us at (949)655-8526
Dropped off in person at 1630 Riggins Road, Tallahassee, FL 32308
or emailed to melissa@ihcfl.com
Please print and fill out the paperwork and submit it to us ahead of your appointment, along with current insurance card, important records, and all current medicines and supplements.
If it is not possible for you to complete the paperwork ahead of time, please come in 15 minutes before your scheduled appointment time so that this can be completed and entered into your chart.
If it is not possible for you to complete the paperwork ahead of time, please come in 15 minutes before your scheduled appointment time so that this can be completed and entered into your chart.
We currently accept new patients with Medicare, Florida Blue (Blue Cross Blue Shield), United HealthCare and Cigna.
We are out of network with Aetna, Ambetter by Peach State, Humana, Tricare, and UMR. We accept some plans for these insurance companies, depending upon the individual policy restrictions.
We are unable to take Capital Health Plan, Staywell, Wellcare, Lighthouse, Humana Medicaid and most HMOs.
No insurance? We offer a 30% Out of Pocket discount!!
We are out of network with Aetna, Ambetter by Peach State, Humana, Tricare, and UMR. We accept some plans for these insurance companies, depending upon the individual policy restrictions.
We are unable to take Capital Health Plan, Staywell, Wellcare, Lighthouse, Humana Medicaid and most HMOs.
No insurance? We offer a 30% Out of Pocket discount!!
If you have chronic health problems, it will help us serve you and save time if you also complete the Medical Symptom Questionnaire and the Nutrition and Lifestyle Journal along with any others that seem appropriate for you and your symptoms. Additional forms include:
Lyme Questionnaire
Candida Questionnaire
Checklist for Hormone Imbalance - Women
Checklist for Hormone Imbalance - Men
Toxic Exposure Questionnaire
Testing to Determine Heavy Metal Exposure
Depression Anxiety Stress Scales (DASS)
Food Allergy Questionnaire