*Cancellation/No-Show Policy

Please cancel appointments with 24-hour notice, if possible. We appreciate early notification of your change of plans so that we may offer that appointment to another patient in need. We will be happy to assist you in rescheduling your appointment for another date/time. $25.00 “No-Show/Late Cancellation” fee. This fee is not billable to your insurance and would be your responsibility.

*Payment Policy

For patients with insurances, all co-payments or co-insurances and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company.

*All patients are required to pay their co-pay if they decide to have blood drawn from the office.

For your convenience, we accept Master Card, Visa, Discover, Debit, and American Express. Please keep in mind that your insurance benefit is a contract between you and your insurance company. Please be aware that some and perhaps all of the services you receive may be non-covered as per your insurance policy.

*Prescription Refills

Please have your prescriptions refilled at your office visit.

  • If you require refills before your visit, call your pharmacist.
  • Please do not go to the pharmacy and wait for your prescription. Please allow 24-48 hours for your request to be processed.
  • Medications such as antibiotics or narcotics will not be refilled by phone and require an office visit.

*After Hours Care

Phone calls to the main office will be forwarded to our answering service. The on-call physician will be paged for calls requiring immediate attention. All other calls will be directed to our office during regular office hours.

After-hour calls to the physician address concerns about an acute illness or new symptom, or worsening symptoms of an existing illness.


*Cell Phone Policy

In the interest of respect to our patrons, cell phones may not be used inside of the clinic. Cell phone conversations are only permitted in the entrance area outside of the clinic. In addition to the matter of courtesy, there is evidence that cell phones interfere with medical devices.


If other specialty care is required your family doctor will:

  • Refer you to another specialist, if it is medically appropriate.
  • If you are member of a managed care health plan (or HMO), you are responsible for following the rules of your plan. Generally, and HMO requires that you call our office for a referral before seeing a specialist. Each plan has its own regulations – be sure you understand your responsibilities.
  • Please allow at least five (5) business days to process a referral. A written referral will be completed for you by the patient representative.

*Medical Records

A valid release of information form is required by our Medical Records department before records can be copied. Please allow two weeks before copying, if possible.

  • Patients will be charged a fee for copies of their health information.
  • There is no charge for releasing copies of health information directly to other healthcare providers.
  • The fee for copies of health information charges:

1. Request for letters written by the doctor will be $25

2. First 25 pages: $1.00/per page

3. Subsequent pages: $0.25/per page thereafter.

*Filing forms for disability – $25/ processing fee $5/per page to be filled out by the doctor

If you have lab work, blood work, x-rays, biopsies, or other studies performed, our providers will attempt to give you an idea of the usual turnaround time for the result of the study if it is no known at the time of your visit. It is our policy not to give any results over the phone. We will be happy to give you any copy of the results in person and with the doctor’s approval.

*Narcotics Policy

In accordance with our Pain Policy the Alilin Family Medicine will not prescribe or manage chronic pain with narcotics or opioids until seen. In addition, no narcotics will be maintained on the clinic premises. In accordance with recommendations by the Federation of State of Medical Boards, we will direct those patients in need of the use of controlled substances to pain specialists and experts for further evaluation, treatment, and monitoring.

“We strive to offer the best services and care for each patient in a timely manner. The above “rules” are essential and necessary to efficiently manage a busy clinic. Thank you in advance for your cooperation and understanding!”