For Patients

At General Physician, PC, we want you to feel comfortable and in control of your care at all times. That’s why we feel it’s important for us to provide a variety of resources to improve your patient experiment and keep you informed on health and wellness.

 

Medical Record Forms.

  • NEW!! Medical Records REQUESTS
    CLICK HERE to access the web portal to request your medical records. Follow the directions and prompts provided. If you have any questions, please contact your providers office.

  • Medical Record Amendment Form
    CLICK HERE to download the form to amend your medical record. 
    • In accordance with the HIPAA Privacy Rule, patients have the right to request an amendment to their health records. Patients will need to complete and mail the form to the address listed at the bottom of the document. General Physician, P.C.  will notify the patient, in writing, once GPPC receives the patient’s written Request.


New Patient Forms.

If you’re a new patient with General Physician, PC, we encourage you to contact your provider's office and request any forms needed prior to your appointment. This will help speed up the check-in process so you can see your provider in a timely manner.

NYS Record Release Form

 

Breast Care Forms.

Click here to download the Patient History Form. Please fill out and bring this form with you to your next appointment.

 

Excelsior Pass.

Click here to go to the webpage and get the app for your Excelsior Pass.

 

Gastroenterology Forms.

PREP INSTRUCTIONS FOR:

• Colonoscopy: Click here to download your colonoscopy PREP Instructions.
• Upper Endoscopy (EGD): Click here to download your Upper Endoscopy PREP Instructions.
• Flex Sigmoidoscopy (EGD): Click here to download your Flex Sigmoidoscopy PREP Instructions.
• Esophageal Manometry (EGD): Click here to download your Esophageal Manometry PREP Instructions.

 

No-Fault Form.

Click here to download the form. Please fill out and bring this form with you to your next appointment.

 

Patient Form Request - Fee Information.

There is a charge for the completion of medical forms (i.e. disability, FMLA, school forms, etc).  Please consult with the office concerning this fee, as it may change from time to time.

 

Women's Health Forms.

Click here to download the "Forms Completion Requisition" (if you are requesting forms from our office, you will need to download, fill this out and return to us)

 

Workers Compensation Form.

Click here to download the form. Please fill out and bring this form with you to your next appointment.

 

Patient Forms.

If you’re a patient with General Physician, PC, we encourage you to log into the patient portal for the following forms

  • Health Care Proxy 
  • NY Authorization Release of Health Info 

Patient Portal Login

 

Accepted health insurances.

We accept most major health insurance plans available in Western New York.  

  • Aetna Medicare 
  • Blue Cross Medicaid - Amerigroup
  • BlueCross BlueShield 
  • EMBLEM/GHI - PPO (FEHP) and EPO lines of business ONLY
  • Empire Plan - NYSHIP (UHC Plan - No YLS Prefix) 
  • Excellus BlueCross BlueShield PPO (participate via Blue Card) *** 
  • Fidelis Care - (all LOB except long-term care) 
  • HUMANA - Commercial Plans: Choice Care PPO
  • HUMANA - MCR Advantage Plans: HMO, PPO, Private Fee for Service 
  • Humana Military 
  • Independent Health (all LOB)
  • KALOS (Gold Plan) 
  • Lifetime Benefit Solutions/RMSCO (self-funded via 3rd party network)
  • MAGNACARE (Includes Aetna) 
  • Martin's Point 
  • Medicaid Pennsylvania - SELECT PROVIDERS ONLY - Per Grid
  • Medicare
  • Medicare Railroad
  • MULTIPLAN (CIGNA) /PHCS
  • MVP (CIGNA) (NALC) Wellselect Plan
  • NOVA
  • NYS Department of Labor
  • POMCO (self-funded via 3rd party network)
  • Today's Options
  • Tricare Prime
  • Tricare Standard
  • United Healthcare
  • Univera
  • UPMC - SELECT PROVIDERS ONLY - Per Grid
  • VA ADMINISTRATION w/authorization only
  • WellCare
  • Worker's Compensation

If you have questions about your insurance, please send us a message.

 

Financial Hardship.

If you are a patient at one of the following primary care locations ask your provider about the sliding scale discount program.

These locations have a financial hardship application available. Buffalo-1091 Main St., Dunkirk

Note: This practice serves all patients regardless of ability to pay. No one will be denied access to services due to inability to pay. There is a discounted/sliding fee schedule available based on family size and income. Call your office for more information.

 

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