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Instructions:
Click on this link. Open and print the four links you will locate here
Fill out all four forms and bring them with you at your appointed time.
http://wrightstatephysicians.org/ortho/forms.html:
You will need to print:
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Patient Registration Form
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Health History Form
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HIPAA Form
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Release of Medical Information Form
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Good Samaritan Health Center
6251 Good Samaritan Way
Suite 120
Huber, Heights, OH 45424
(937) 208-2091
Office Hours:
Monday 8:00 Am to 6:00 PM
Thursday 1:00 PM TO 5:00 PM
Friday 8:00 AM to 12:00 PM |
Miami Valley Hospital
30 E. Apple Street
Suite 2200
Dayton, OH 45429
(937) 208-2091
Office Hours:
Tuesday 8:00 AM to 5:00 PM |
Miami Valley South Hospital
2350 Miami Valley Drive
Suite 210
Centerville, OH 45459
(937) 208-2091
Office Hours:
Wednesday 8:00 AM to 5:00 PM
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Dr Barbour's office accepts all HMO & PPO Insurance Plans, Medicare/Medicaid Assignment, and Workmen’s Comp.
We also accept:
"When our feet hurt, we hurt all over"
-Socrates
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