Lifespan Physician Group Pediatric Primary Care Co-Pays and Fees

Co-pays are due at the time of the visit. A $10 fee will be added to the co-pay if it is not paid at the time of the visit. We will accept cash, check, Visa or MasterCard. Please update your insurance information at each visit so we charge you appropriately. Each time you receive a new health card we will need to make a copy for our records. We appreciate your cooperation in this matter.

We reserve the right to charge a $35 fee for missed appointments or appointments cancelled with less than twenty-four hours notice. Missed appointments often mean someone else was not able to be seen in a more timely fashion.

Over the years we have experienced a steady increase in the need for forms to be filled out. A completed state school physical examination form and a copy of your child’s immunizations will be provided at each well visit. This exam form will be good for one year. You can make additional copies for sports and other activities as needed throughout the year. We will charge a $15 fee for any additional or lost physical exam forms that need to be filled out. Additional forms will not be completed unless the $15 fee is paid for in advance and all other needed information has been filled out on the form. Please allow one week for completion of any additional forms.