Welcome, and thank you for your interest in joining Churchville Chili Family Medicine. For over 25 years, CCFM has been committed to providing its patients with quality care. Building and maintaining healthy provider-patient relationships through communication is an important part of your care. Please read the Practice Policies & Procedures carefully:
This document is updated as needed (at least once a year), and outlines all the fundamental policies in this PPP document regarding:
A) Appointments
B) Medications & Refills
C) Financial & Billing
D) Insurance Plans
All Patients are required to review and sign as acknowledgement that you have read all sections.
Thank you in advance for your cooperation in achieving our mutual goals. We take your health care seriously.
Our Notice of Privacy Practices is posted on our website and at our entrance.
Please note: You may request a printed copy of the PPP document and/or Notice of Privacy Practices at any time.
Failure to comply with your plan of care may result in release of care from our practice.
A) Appointments
B) Medications & Refills
C) Financial & Billing
D) Insurance Plans
All Patients are required to review and sign as acknowledgement that you have read all sections.
Thank you in advance for your cooperation in achieving our mutual goals. We take your health care seriously.
Our Notice of Privacy Practices is posted on our website and at our entrance.
Please note: You may request a printed copy of the PPP document and/or Notice of Privacy Practices at any time.
Failure to comply with your plan of care may result in release of care from our practice.