Please plan to come to your visit 15 minutes before the scheduled appointment to allow time for required processing which includes:
1. Registration – You may visit our patient portal at any time (especially prior to your visit) and update all you information including insurance, demographic and history and physical information If you do not have a user name and password for the portal, call the office today!
2. Insurance – Please bring your insurance card to every visit.
3. Medication lists, weight, height and blood pressure – All are checked when appropriate by our medical staff along with the reason for your visit. Bring your list!
4. Forms – Please bring and present at registration any forms you anticipate will need completion. If you need an updated referral, bring a list of the physician’s name and what condition you see them for. Let us know before your visit if you will need an interpreter.
5. Office Access – The office is at ground level with no stairs to climb for access. We do not have the ability to assist patients with mobility difficulties into or out of the office from the parking lot. Please bring help if you need it.
6. Staying connected – Call to become web enabled so that you may access our patient portal and update and access all your information electronically.
7. Cancellation Policy or Rescheduling Appointments
- For Physicals – The appointment has been reserved for an extended amount of time for you. If there is a need to cancel or reschedule, please do so at least 48 hours in advance in order to allow other patients access at this time. If this appointment is cancelled or rescheduled with less than 48 hours notice, you will be responsible for a $50 late cancellation fee.
- For all other appointments – If there is a need to cancel or reschedule, please do so at 24 hours in advance to avoid a $25 cancellation fee.
Sec 1557 – Notice of Non Discrimination
RIDGEWOOD MED-PEDS, LLP complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.
ATTENTION: If you speak a language other than English, and are in need of language assistance services please contact Jo Anne Fournier, our Practice Administrator (585-225-1700 ext 236 – email: email@example.com), for assistance. Language assistance services, for most languages, are available to you free of charge.
Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement:
Discrimination is Against the Law
RIDGEWOOD MED-PEDS, LLP complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. RIDGEWOOD MED-PEDS, LLP does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
RIDGEWOOD MED-PEDS, LLP:
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, contact Jo Anne Fournier (Practice Administrator) – 48 hr advance notice is requested, but not required.
If you believe that RIDGEWOOD MED-PEDS, LLP has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Jo Anne Fournier, practice Administrator, [Fax: 585-225-1439], [firstname.lastname@example.org]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Jo Anne Fournier is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.