New Patient Forms

If you are interested in becoming a patient please complete and return the attached forms and one of our staff with contact you to set up your first appointment.

Our Financial Policy – Frequently asked questions regarding payment terms and forms of payment.

Notice of Privacy Practices – How we protect your identity and information.

Record Request (Incoming) – Use this to request records from another office to send to Family Medicine at Greenhill.

Insurances we accept for New Patients
Amerihealth
Cigna Health Springs
Highmark HealthOptions
Highmark Medicare Advantage
Humana Medicare Advantage
Medicaid of Delaware
Medicare
Railroad Medicare
United Dual
UnitedHealthCare Medicare Advantage

Insurances we may/may not accept depending on the coverage for New Patients

Aetna Commercial
Highmark Commercial
Humana Commercial
United HealthCare Commercial
Insurances we DO NOT ACCEPT for New Patients
Administrator Concepts
Aetna Medicare Advantage
AmerHealth NJ
Anthem BCBS
Champva
Chesterfield Resources
Cigna
Coventry
Federal BC
GPA
Independence Administrators
Independence Blue Cross
Keystone Health Plan
Liberty Health Share
Medicshare Christian
Meritain Health
Out of State BC
Tricare
UMR