A few forms, facts, and figures for new and existing patients.
On your first visit to CJIMA, please bring your current insurance card, referrals, list of your medications, and your patient records. Please arrive 15 minutes prior to your appointment time for processing of paperwork, or print and complete the forms ahead of time: Demographic Information, Health History, Electronic Prescriptions, and Medical Records Request.
It is the patient’s responsibility to notify our office of any demographic or insurance carrier updates. If you have any changes, please complete the Demographic Information Update and bring it to your next visit.
The patient portal allows you to communicate with our clinics online. You can use it to view or request appointments, refill prescriptions, view your billing statement, and more. If you do not have a username and password, please call our office to receive them.
Prescription refills will be provided only to patients who have had an office visit in the previous six months. Your request will be reviewed and refilled in 48-72 hours. We follow strict protocols for controlled medications, so patients must be seen by a physician every 90 days when taking one.
Cancellations and co-pays require payment by the patient. A 24-hour cancellation notice is required for all appointments with a fee of $50 assessed if less than 24 hours notice is given. All co-pays are due at the time of medical service, the amount varying depending on your plan and coverage.
CJIMA requires 3-5 business days to process referrals or authorizations. Please call us on our referral line at 732-828-0002, Option 2, and provide: Patient’s Name, Date of Birth, Call Back Number, Specialist’s Name, Appointment Date, and Reason for Visit.
Medical records requests require written authorization from the patient or parent/guardian. A third-party vendor handles all CJIMA’s medical record requests and can be reached at: Med Request Solutions, P.O. Box 23, South River, NJ 08882. Tel: 800-483-6040.
CJIMA’s patient-service procedures are informed by the Comprehensive Primary Care Initiative (CPCI), which aims to provide better resources and a more supportive multi-payer payment model for all patients.