Office & Patient Information

Our main office is the Orlando office. All appointments, insurance, billing and medical records are through the Orlando office. The Orlando office hours are 9:00 AM to 5:00 PM Monday through Friday. The Orlando office phone number is 407-902-2866, if you are calling long distance you may call our toll free number at 1-800-470-6672.

Appointments

Please contact us at 407-902-2866 or 1-800-470-6672 and enter

option -1- to schedule an appointment at any of our Central Florida

locations. When calling, please have your insurance card available

as we will need insurance information to complete your appointment.

If you are a new patient an informational packet will be mailed to you, or

you may download and print the new patient form packet. Please

complete this packet and bring it to your scheduled appointment.

Complete and bring with you for your first visit a Patient Information Form and a History Form.

All forms are in Adobe Reader.

Free download for Adobe Reader 7.0

New Patient Information Form in English

New Patient History Form in English

New Patient Information Form in Spanish

New Patient History Form in Spanish

As a courtesy, we will do our best to contact you as a reminder of your scheduled appointment. We do ask that you provide us with 48 hours notice of any appointments that you may need to reschedule or cancel.

If you are an existing patient and have not been seen in the last three months, we ask that you download, print and fill out the forms and bring to your upcoming appointment.

Existing Patient Follow-up Form in English

Existing Patient Follow-up Form in Spanish

Always bring your insurance card at the time of your appointment. This will shorten your wait time. Our billing and referral department will make every effort to acquire benefit information before you arrive for your appointment. They will make every effort to notify you of your responsibility for any payment. Please come prepared to pay your co-pay, any deductibles, or any other remaining balances. If you need assistance with payments, please contact the billing manager at 407-902-2866 or 1-800-470-6672 enter option - 2-.

Insurance

We participate in most HMO and PPO insurance plans (click here to see a list of insurance plans we are on). If your have any questions regarding a specific plan, please call our office at 407-902-2866 or 1-800-470-6672 enter option -2- or -0- or you may e-mail our insurance department at rmason@carson-appleton.com and we will be happy to assist you.

Pre-authorization is required by many plans. It is your responsibility to contact your primary care physician regarding your scheduled appointment at this office and obtain the pre-authorization form. Failure to do so may result in denial of a claim or rescheduling of your appointment. If you need help in acquiring your referral, please contact our referral department at option -3- and we will be happy to assist you.

After Hours

Our business hours are 9:00 AM to 5:00 PM, Monday through Friday. If you must speak to the physician on call, please contact any of our main office numbers and a physician will return your call as quickly as possible. If you do not receive a call back within 30 minutes, please try again. Please refrain from calling after hours for questions that can be answered during business hours.

Prescription Refills

Please notify our office in advance when a prescription refill is needed. Allow 48 hours for the request to be processed. Please contact our office at 407-902-2866 or 1-800-470-6672 enter option -5- and leave the following information or you may e-mail the following information to jtaylor@carson-appleton.com :

Child's name and date of birth

Current weight of child

Name of the medication and dosage

Pharmacy name, pharmacy phone number and fax number

Telephone number where you can be reached in case of questions

Medical Records / HIPAA Privacy

Patients are required to sign a Patient Authorization Form for Use and Disclosure of Protected Health Information to obtain a copy of any medical records within our practice. We must have written consent from the parent or legal guardian of the patient to disclose medical information to any family member. The forms can be downloaded below. If you have any questions, please contact our Medical Records Coordinator at 407-902-2866 or 1-800-470-6672 enter option -4- or e-mail cashby@carson -appleton.com

HIPAA Notice of Privacy Practices

HIPAA Polices and Procedures of Patient Rights

This internet site provides information of a general nature and is designed for educational purposes only.

If you have any concerns about your own health or the health of your child, you should consult with a physician or other healthcare professional.

	Carson & Appleton, M.D. \| home About Our Doctors \| Our Affiliates \| Medical Services \| Heart Conditions/FAQ \| Office & Patient Information \| News & Events \| Our Patients \| Locations & Maps \| Contact Us Specializing in Fetal, Pediatric & Adult Congenital Cardiology
	Office & Patient Information Our main office is the Orlando office. All appointments, insurance, billing and medical records are through the Orlando office. The Orlando office hours are 9:00 AM to 5:00 PM Monday through Friday. The Orlando office phone number is 407-902-2866, if you are calling long distance you may call our toll free number at 1-800-470-6672. Appointments Please contact us at 407-902-2866 or 1-800-470-6672 and enter option -1- to schedule an appointment at any of our Central Florida locations. When calling, please have your insurance card available as we will need insurance information to complete your appointment. If you are a new patient an informational packet will be mailed to you, or you may download and print the new patient form packet. Please complete this packet and bring it to your scheduled appointment. Complete and bring with you for your first visit a Patient Information Form and a History Form. All forms are in Adobe Reader. Free download for Adobe Reader 7.0 New Patient Information Form in English New Patient History Form in English New Patient Information Form in Spanish New Patient History Form in Spanish As a courtesy, we will do our best to contact you as a reminder of your scheduled appointment. We do ask that you provide us with 48 hours notice of any appointments that you may need to reschedule or cancel. If you are an existing patient and have not been seen in the last three months, we ask that you download, print and fill out the forms and bring to your upcoming appointment. Existing Patient Follow-up Form in English Existing Patient Follow-up Form in Spanish Always bring your insurance card at the time of your appointment. This will shorten your wait time. Our billing and referral department will make every effort to acquire benefit information before you arrive for your appointment. They will make every effort to notify you of your responsibility for any payment. Please come prepared to pay your co-pay, any deductibles, or any other remaining balances. If you need assistance with payments, please contact the billing manager at 407-902-2866 or 1-800-470-6672 enter option - 2-. Insurance We participate in most HMO and PPO insurance plans (click here to see a list of insurance plans we are on). If your have any questions regarding a specific plan, please call our office at 407-902-2866 or 1-800-470-6672 enter option -2- or -0- or you may e-mail our insurance department at rmason@carson-appleton.com and we will be happy to assist you. Pre-authorization is required by many plans. It is your responsibility to contact your primary care physician regarding your scheduled appointment at this office and obtain the pre-authorization form. Failure to do so may result in denial of a claim or rescheduling of your appointment. If you need help in acquiring your referral, please contact our referral department at option -3- and we will be happy to assist you. After Hours Our business hours are 9:00 AM to 5:00 PM, Monday through Friday. If you must speak to the physician on call, please contact any of our main office numbers and a physician will return your call as quickly as possible. If you do not receive a call back within 30 minutes, please try again. Please refrain from calling after hours for questions that can be answered during business hours. Prescription Refills Please notify our office in advance when a prescription refill is needed. Allow 48 hours for the request to be processed. Please contact our office at 407-902-2866 or 1-800-470-6672 enter option -5- and leave the following information or you may e-mail the following information to jtaylor@carson-appleton.com : Child's name and date of birth Current weight of child Name of the medication and dosage Pharmacy name, pharmacy phone number and fax number Telephone number where you can be reached in case of questions Medical Records / HIPAA Privacy Patients are required to sign a Patient Authorization Form for Use and Disclosure of Protected Health Information to obtain a copy of any medical records within our practice. We must have written consent from the parent or legal guardian of the patient to disclose medical information to any family member. The forms can be downloaded below. If you have any questions, please contact our Medical Records Coordinator at 407-902-2866 or 1-800-470-6672 enter option -4- or e-mail cashby@carson -appleton.com HIPAA Notice of Privacy Practices HIPAA Polices and Procedures of Patient Rights © 2005 Carson & Appleton, M.D. All rights reserved. This internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should consult with a physician or other healthcare professional.