Working Together to Improve Your Health

Patient Information

Thank you for choosing the Adonai Diabetes & Endocrinology Center for your health care needs. We look forward to providing you and your family compassionate care. Below you will find the information you need to understand how the clinic works. Our clinic policies are included in the pre-visit information packet that you will be asked to sign, acknowledging your awareness of and willingness to comply with these policies. Please call with any additional questions you may have.

CLINIC POLICIES AND OPERATIONS

Forms

Release of Information
New Patient Forms
Diabetes History Form
Follow-up Visit Questionnaire
Follow-up Visit – Diabetes
HIPAA Patient Rights
Radioiodine Guidelines
Low Iodine Diet Guidelines
iPro Patient Log
Glucose Log – 24 Hour
Glucose & Insulin Log

Your First Visit

All new patients should arrive 15 minutes prior to their first appointment to complete necessary paperwork.
What to bring for your first appointment:

Insurance card
Photo ID or driver’s license
Current medications – Bring your bottles, please!
List of questions or concerns

Pre-Visit Forms

Prior to your appointment you will be asked to complete several forms. Completing and returning these forms prior to your visit will make your appointment go more smoothly. If you have diabetes, there is a special diabetes history form for you to complete. These forms are available under the “Forms” section of our website.

Follow Up Visits

What to bring for each appointment:

Insurance card
Photo ID or driver’s license
Current medications – Bring your bottles, please!
List of questions or concerns

We ask that you make your follow-up appointments prior to leaving the office. If you are unable to do this, please call us as soon as possible to schedule your next visit and any laboratory or radiology studies that are needed prior to that visit.

Each time you return for a visit you will be given a brief follow-up form to complete that updates your health history information and your medications. Please bring all of your medications (prescription and over-the-counter medicines) to each visit.

We will call to confirm your appointment 1-2 business days prior to your appointment.
If we are unable to reach you, we will leave a message (when possible).
If we are unable to reach you, your appointment may be rescheduled to a later date.

If you fail to keep your appointment or do not cancel more than 24 hours prior to the appointment, a $100 fee will be charged directly to you and not your insurance company.

If you fail to keep your appointments 3 times, these will be grounds for termination of the doctor-patient relationship.

Diabetes Education

Care Provided

We strive to provide high quality consultation reports that address the symptoms and concerns of our patients. The results of the clinical evaluation, laboratory studies and radiology reports will be shared with your primary care provider. We will schedule a follow-up visit with you to review the laboratory and radiology results. At that time, we will start or evaluate the treatment plan.

We do not provide primary care to patients.

This is a medical subspecialty practice, so all patients are required to have a primary care provider. If you do not have a primary care provider, we will offer you the names of local providers.

We do not provide acute or chronic pain management.

If these medical services are needed we will make appropriate referrals.

We will make referrals to other providers as necessary to provide you with the care you require.

We will assist you in making those appointments or you may do so yourself.

All care is provided in person.

Laboratory results will not be provided over the telephone in place of an office visit.

Patient Rights

Be seen in a timely manner.
Be treated with respect.
Participate in all medical decisions and selection of treatments.
Be aware of possible complications and side-effects of recommended treatments.
Have written instructions describing your care plan.
Receive prompt attention for urgent and emergent medical conditions.
Receive prompt and appropriate referral for needed services.
Respect for the privacy of your personal health information.

Patient Responsibilities

Keep and be on time for appointments.
Treat all care team members with respect.
Follow treatment recommendations and treatment plans.
Immediately report all treatment complications and if treatments are stopped.
Read and implement written instructions.
Seek attention at urgent care and emergency facilities if this is office is closed or is not the best place to receive the needed care.
Follow recommendations for referrals to other providers.
Complete necessary forms for compliance with privacy regulations and for
release of information.

The only thing that matters is faith expressing itself through love. Galatians 5:6

The more you understand about your diabetes, the longer you will live.

Call today: 907-357-2332