Your First Visit

Welcome to Potter Plastic & Reconstructive Surgery

Thank you for choosing our practice with your care.

For your first visit to our office, we request you bring with you the following information.  Please arrive 10-15 minutes prior to your appointment time to allow for paperwork.  If you wish to fill out the patient registration and health history forms in advance, a packet can be mailed or e-mailed to you upon request.

  • Payment and/or co-pay for your visit.  We accept cash, check, credit card (Visa, MasterCard, Discover, and American Express) or M-Lend.  Please visit the M-Lend website to learn more about your balance financing or apply online.
  •  A list of all current medications you are taking.
  •  Name and phone number of your primary care physician.
  •  Insurance information (where applicable)

Your insurance card or contract ID and group number.

Name of your insurance carrier and claims address.

Phone number for your insurance carrier.

Name of subscriber with social security number and date of birth.

Download and Complete the New Patient Registration Forms and Patient Privacy Policy and bring them to office for your first visit.

Please contact our office via email or phone if you have any questions.


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