VSP

In order to verify your insurance and confirm we are providers, we will need the insurance ID or the last 4 digits of the primary member's social. Without this information, we cannot proceed in making an appointment. VSP and its affiliates (e.g., Cigna Vision, Met Life, etc.) requires us to obtain this Information.

Patient's Name(Required)

First Last

Are you the primary member?(Required)

Yes

Primary Members First and Last Name

First Last

Primary Members Date of Birth

Insurance ID number(Required)

The ID number may be a unique number or the last 4 digits of the primary member's social security number.

Phone number of insurance

Please provider the phone number for the insurance if available.

Name

This field is for validation purposes and should be left unchanged.

MASK WEAR MAY BE REQUIRED FOR THE PATIENT AT THE DISCRETION OF THE DOCTOR. We are open by APPOINTMENT ONLY. In order to be seen for the appointment, you must read and stay up to date on our health protocols Read Our Heath/Safety Guidelines Post…

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770-917-2221

VSP

Douglasville Office Hours & Location

Menu

770-917-2221

VSP

Douglasville Office Hours & Location

NO MEMBERSHIP NEEDED