Growth and Development Forms
- Consent to Treat a Minor
- 1 Month Visit
- 2 Month Visit
- 4 Month Visit
- 6 Month Visit
- 9 Month Visit
- 12 Month Visit
- 15 Month Visit
- 18 Month Visit
- 2 Year Visit
- 2+1/2 Year Visit
- 3 Year Visit
- 4 Year Visit
- 5 Year Visit
- 6 Year Visit
- 7 Year Visit
- 8 Year Visit
- 9 Year Visit
- 10 Year Visit
- Early Adolescent Visit
- 15-17 Year Visit
Preventative/Annual Health Exam (PME)
School and Sports Forms
Privacy Notice Forms
FMOA Financial Policy
YOUR MONEY MATTERS
Family Medicine of Albemarle would like to inform you of some of our billing practices to help you manage your money wisely.
Your coverage is a relationship directly between you and your insurance company. We are not able to answer questions about what your individual policy will cover.
If you have questions about tests, exams, co-insurance, copays and summary of benefits, please contact your insurance company directly.
If you pay in cash or are a self- pay patient, FMOA requests that you provide a $50 copay at the time of check in. Please be prepared to pay for your visit in full or provide a credit to be placed on file.
There is 20% discount for self-pay if the full bill is paid at the time of service.
Physicians are on-call and can answer your questions. If they provide you care via the phone, they may bill you for their time and expertise if a following visit is not scheduled in the office.
Labs: tests may be ordered during a preventive exam that your insurance company will not cover in full but are important for your care. Prior to ordering these labs we will discuss them with you.