BPT IN OFFICE
- New Patient BRIDGEPORT visit
Your appt is @ our Bridgeport office:
Address is at bottom of confirmation email. - Established Patient BRIDGEPORT visit
Your appt is @ our Bridgeport office. Address is at bottom of confirmation email.
MFD IN OFFICE
- New Patient MILFORD visit
Your appt is @ our Milford Office. Address will be at bottom of confirmation email.
- Established Patient MILFORD visit
Your appt is @ our Milford office:
Address will be at bottom of confirmation email.
TELE HEALTH
- iPHONE USER, TELE HEALTH, NEW PATIENT, CONTACT MY CEL PHONE VIA FACE TIME
- iPHONE USER, TELE HEALTH, NEW PATIENT, CONTACT MY CEL PHONE, VIA GOOGLE MEET
- ANDROID/COMPUTER USER, TELE HEALTH , NEW PATIENT, CONTACT MY EMAIL, VIA INVITE LINK
- iPHONE USER, TELE HEALTH, ESTABLISHED PATIENT, CONTACT MY CEL PHONE, VIA FACE TIME
- iPHONE USER, TELE HEALTH, ESTABLISHED PATIENT, CONTACT MY CEL PHONE VIA GOOGLE MEET
- ANDROID/COMPUTER USER, TELE HEALTH, ESTABLISHED PATIENT, CONTACT MY EMAIL, VIA INVITE LINK
Anthony G. Ciccaglione, M.D.
Please complete your Patient Registration Form AND BRING OR SUBMIT:
1) valid I.D., i.e. driver's license
2) insurance card AND
3) credit card, to be kept on file.
**We will charge your credit card the (insurance) contracted amount, if insurance does not pay, due to deductible, copays, incorrect insurance info and/or non covered services. **
***FOR TELE HEALTH APPTS:***
*DR WILL CONTACT YOU VIA THE EMAIL/CEL NUMBER THAT YOU USED TO BOOK YOUR APPT. PLEASE BE SURE THIS INFO IS CORRECT, AS IT WILL DELAY YOUR APPT. IF YOU NEED TO CHANGE YOUR CONTACT INFO, JUST CANCEL YOUR EXISTING APPT, AND SCHEDULE A NEW APPT WITH THE APPROPRIATE CONTACT INFO.
*PLEASE CHECK YOUR EMAIL THE MORNING OF YOUR APPT AND EXPECT AN INVOICE FOR YOUR COPAY. IT WILL COME FROM OUR "SQUARE" APP AND WILL BE EMAILED TO THE EMAIL ADDRESS THAT YOU USED TO BOOK YOUR APPT. BE SURE TO CHECK YOUR SPAM FOLDER TOO. THIS MUST BE PAID PRIOR TO YOUR APPT. FAILURE TO DO SO MAY CAUSE YOUR APPT TO BE CANCELLED**
Thanks for your cooperation!