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Easily access everything you need to partner with us in your care.

The Patient Portal allows you to access vital records and information wherever you need it. Here, you can securely view records including visit notes and pathology reports, send privacy protected emails with questions or refill requests to your provider, update your medical history, medication list, and preferred pharmacies. You can also view upcoming scheduled appointments, view and pay account balances, and change your contact information, all in one place - when it’s convenient to you.

Care Credit: Financing Patient Care

We are proud to offer the convenience of CareCredit to our patients to assist in financing their cosmetic and out-of-pocket expenses. CareCredit offers no interest short term financing options for 6, 12, 18, or 24 month loan periods, and competitive interest rates for longer terms. Instant approvals are available with a convenient online application or by calling 1-800-677-0718.

Pay a Bill

If you have any questions while paying your bill online, please reach out to our billing department by calling 614-473-9519.

Patient Forms

To save time at the office, please download and fill out our intake forms before your visit. If you would like records from your previous physician forwarded to our office, please complete and return the Medical Records Release form. Click the button to download each form.

To have your records forwarded, sign this form.

Medical Release Form

Read and sign this form if the patient is under 18.

Parental Consent Form

Please read and sign our privacy information.

HIPAA Consent Form

Please read and sign our financial policy.

Financial Policy Form

New patients, please start here.

Patient Intake Form
PRO-NOX SEDATION
Does treatment make you nervous?

Relief takes effect in just a few breaths and is expelled from the lungs within minutes after discontinuation, allowing a quick recovery. Pro-Nox can make procedures much more comfortable and less anxiety provoking for patients. With limited downtime after procedures, patients can drive themselves home within minutes. The 50/50 mix of Nitrous Oxide and Oxygen (also known as “laughing gas”) has been used around the world for decades, and studies have shown that the use of Nitrous Oxide/Oxygen can significantly reduce pain, is non-addictive, and delays or decreases the need for other pain medication, all while providing you comfort and peace of mind during your procedure. Pro-Nox is available for a small additional fee for patients who desire it.

Easily access everything you need to partner with us in your care.

The Patient Portal allows you to access vital records and information wherever you need it. Securely view records including visit notes and pathology reports, send privacy protected emails with questions or refill requests to your provider, update your medical history, medication list, and preferred pharmacies. You can also view upcoming scheduled appointments, view and pay account balances, and change your contact information, all in one place - when it’s convenient to you.

Our No-Show Policy

It is our policy to charge a $35 fee for missed appointments unless we receive notice 24 hours in advance. 

 

No shows for double appointments, longer appointment slots, surgical appointments, or two day procedure appointments may result in higher or multiple no-show fees (these charges are subject to change without notice).

 

Please reach out to reschedule your appointment if you will be unable to make it.

Though we are sympathetic to the variety of circumstances that can lead to missed appointments, holding a spot for a patient who does not arrive to be seen creates wide-reaching problems in our clinic. 

 

Even if a patient does not arrive, there are costs associated with having providers available, clinic space reserved, and tools and technology ready at the time of the missed appointment. The fee we assess helps to offset overhead costs spent regardless of whether a patient is seen or not.