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New Patients of Mercy Health Physician Partners OB/GYN East Beltline
Dear Patient,
We at Mercy Health Physician Partners OB/GYN East Beltline are thrilled that you have chosen us to care for you. Providing health care for women requires a special touch — compassion, blended with expertise. At Mercy Health Physician Partners OB/GYN East Beltline, you will find considerate, skillful, knowledgeable professionals who share the common goal of caring for women with kindness, compassion and excellence.
As a new patient, we need you to complete the information and insurance forms located below, prior to being seen. The doctor can not treat you until they have been completed.
In preparation for your first visit, please bring the following with you to your appointment:
- Completed 1-page Registration Form
- Signed Financial Policy Statement
- Completed Patient Questionnaire
- Verification of your insurance coverage (your insurance card)
- Copay (all copays and payment for non-covered services)
- Pertinent medical records for the problem that we will treat
Arrive at least 15 minutes prior to your appointment time so that together we may have time to verify your new patient information and insurance information.
As a courtesy to you, we will bill your insurance company. We will copy your insurance card at every appointment. We do expect that you will pay your copay the day of your visit. For your convenience, we accept cash, personal checks, and credit cards (MasterCard and Visa).
We recommend that you call our office just before leaving for your appointment to verify that your physician is in. Because our physicians are obstetricians as well as gynecologists, there are occasional unforeseen deliveries and emergencies. We do apologize for any inconvenience this may cause you.
It is your responsibility to know what services your insurance plan and policy covers (i.e. which laboratories, procedures, treatments, radiologists and doctors your insurance will accept).
Thank you for the opportunity to serve you. We look forward to meeting you!
Sincerely,
Kirsten L. Anderson, MD
Sejal Bennett, MD
Kerry L. Gorsuch, MD
Geron D. Turke, DO
Trisha Zylstra, MD
Mercy Health Physician Partners OB/GYN East Beltline
1471 East Beltline NE, Suite 101
Grand Rapids, MI 49525 Map
Phone: 616-685-8600
Fax: 616-365-0057
Email Us
Patient Questionnaire
Patient Registration
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