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Forms and Insurance Info


The following forms are available upon request:

  • Patient registration
  • Insurance
  • Initial History
  • Follow up Medical Forms
  • Authorization for Medical Treatment
  • Privacy (informational)
  • Notice of Privacy sign off
  • Financial Policy
  • Credit Card Authorization
  • Records Release Outgoing
  • Photo Authorization
  • Cancellation Policy

Patient portal will be available soon – please check back.

Insurances Accepted:

Most insurance accepted. If the doctor happens to be out of network, we will assist Dr. Saukin’s patients with insurance reimbursement whenever possible.