Forms

Instructions to get to the office.

http://drharoldgoodman.com/wp-content/uploads/2014/08/How-to-get-to-the-office..pdf

General intake form.

Print and fill this out and bring it to your first visit.

http://drharoldgoodman.com/wp-content/uploads/2014/10/Intake_hippa.pdf

Medicare patients

Dr. Goodman is Medicare opt-out. This means that he does not participate in Medicare. However, if you have secondary, supplemental insurance then you may  submit the following form along with your superbill to the insurance company and, according to your policy, request reimbursement. As with any insurance contract, the company will determine what, if any, reimbursement they will provide according to the details of your contract with them.

Please download, print and fill in this form. Bring it to the initial visit.

Medicare Contract

Car accidents

Please download, print, and fill this out and bring it with you when you visit the office.

http://drharoldgoodman.com/wp-content/uploads/2014/08/MVA.pdf