Kidney Specialists, PLLC
Kidney Specialists, PLLC

Patient Forms

Want to save time during your visit with us? Please print and fill out the following forms and bring with you on your first appointment.

 

Please note that all of these forms have to be filled and brought in to the office at the time of the initial visit.

New patient registeration form
Initial Form.pdf
Adobe Acrobat document [711.5 KB]
Notice of Privacy
NoticePrivacy.pdf
Adobe Acrobat document [1.4 MB]
Assignment of Benefits
AssignmentBenefits.pdf
Adobe Acrobat document [258.6 KB]

Please don't forget to bring a form of ID and your insurance information with you

 

In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

 

We also accept uninsured and self-pay patients. We are able to set up a payment plan if the charges exceed your budget.

We accept most types of health insurance. Please contact us for further details.

Locations:

 

1004 Sushruta Drive

Suite A

Martinsburg, WV 25401

 

Phone

(304) 449-3778

 

Fax

(304) 449-3777

 

 

 

1870 Amherst Street

Medical Office Building 1,

Suite 2A

Winchester, VA 22601

 

Phone

(540) 313-6563

 

Fax

(304) 449-3777

 

 

 

320 North Royal Ave

Front Royal, VA 22630

 

Phone

(540) 313-6563

 

Fax

(304) 449-3777

 

 

Email:

info@KidneySpecialists.info

 

 

Office Hours

 

Martinsburg:

 

Tuesday, Thursday: 8:30am to 4:30pm

 

 

Winchester:

Moday, Wednesday: 8:30am to 12:30pm

 

 

Front Royal:

Wednesday: 1:30 to 4:30

 

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