Cardiology of Central Alabama Patient InformationUAB Heart & Vascular Clinic at Russell Medical

CARDIOLOGY OF CENTRAL ALABAMA PATIENT INFORMATION


Please complete and bring the enclosed forms to your appointment
	Patient Information
	Patient Medical History \| New Patients
	Patient Health Status Update \| Existing Patients
	Medication List
	Privacy Notice Acknowledgement
	Authorization for Release of Protected health Information to CCA
	Consent to Treatment and Payment
	Cancellation \| No Show Policy
Please arrive 15 minutes prior to your appointment time so we may complete your registration.
Please bring lab work you have had completed outside of our office, especially lave work that includes cholesterol levels and liver functions.
Please bring recent EKG if performed outside of our office.

Cancellation Policy

Patients who do not keep their appointments or provide 24 hour notice of cancellation will be subject to a charge of $25.00. This fee is not a billable charge to any insurance company and is the responsibility of the patient. If a patient misses or cancels 3 times, we reserve the right to dismiss that patient from the care of Cardiology of Central Alabama.

How to Cancel your Appointment

To cancel appointments with Cardiology of Central Alabama call 256-234-2644 at least 24 hours in advance. Messages left on the CCA voicemail the night before your appointment will not be considered to have met the cancellation guidelines.

No Show Guideline

A “no show” is someone who fails to present at the time of a scheduled appointment. Patient’s who show up later than 30 minutes after their scheduled appointment will be considered a “no show”.

Prescription Refills

Please request cardiac medicine refills during your office visits, if possible.

Refills cannot be handled after regular business hours.

When you have no less than one week of medicine remaining, please have your pharmacy fax over a prescription refill request to our office.

If you call the office about your prescriptions, your call will be routed to the prescription line, which is monitored by our clinical staff. Please allow 24-48 hours for prescription refills.

Test Results

Once we receive your test results and the physician reviews them, we will contact you if there is a need to adjust your medication or the results necessitate action. All nuclear stress tests and echocardiogram results will be called directly to the patient.

Financial Issues

Questions regarding your billing statement may be directed to our billing specialist. Please call 256-234-2644 extension 11.