Please
review our office policies, prior to making your appointment.
SCHEDULING APPOINTMENTS
Please call 201.567.3370 and our staff will help you schedule
your appointment, or answer any questions you may have.
FINANCIAL RESPONSIBILITY
Payments are due at the time of service. Co-pays and Balances
are to be paid at the time of visit, without exception.
Our office accepts checks, cash, and the following credit
cards:
It is important to be aware of your insurance plan policies
regarding: co-payments, deductibles, co-insurances, in-
and out of network status and responsibilities, and referral
requirements.
MISSED OR CANCELLED APPOINTMENTS
If you are unable to keep an appoinment, we ask that you
kindly provide us with at least 24-hour notice.
Patients that miss or cancel their appointment with a specialist,
Jerald Zimmerman, MD with less than 24-hour notice will
be charged a NO SHOW or FAIL TO CANCEL fee.
REFERRALS
If you know you need a referral, please call the office
at 201.567.3370.
Please provide the following when requesting a referral:
Your Current Medical Insurance
Your Phone Number
Your Diagnosis
Specify how to send the referral (Mail or Pick-up). We do
not fax referrals.
Name of the Doctor (for whom you need a referral)
Specialty of the Doctor
Doctor's Provider ID
Doctor's Office Phone Number
Doctor's Fax Number
Doctor's Office Address
Appointment Date
MEDICATIONS AND REFILLS
We will not refill medications outside of our office hours.
Please provide us with at least 48 hours notice for when
you need a refill.
Most pharmacies will provide a three-day emergency supply
of a medicine without a doctor's approval if you forget
to have it refilled prior to a weekend.
Prescription drugs must be regulated carefully. If you have
not been seen for a while, you may be required to come in
for an evaluation. This ensures the safe use of sometimes
dangerous medications.
CONTROLLED SUBSTANCES
These are drugs closely monitored due to their potentially
addictive nature.
Be aware that they often require monthly visits to obtain
hard copies of the prescription.
CONFIDENTIALITY AND YOUR PROTECTED HEALTH INFORMATION
All of your medical records and communications are completely
confidential and may be released to a third party only with
your written permission.