Patient Information

Hospital Affiliations

• Gulf Coast Medical Center
• Cape Coral Hospital
• Lee Memorial Health System
• Health Park Hospital

Dialysis Affiliations

• Davita Dialysis Centers located in Lee and Collier Counties
• Fresenius Kidney Care located in Lee County
• American Renal Associate (ARA) located in Lee County

Your First Appointment

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

• Patient’s insurance card
• List of current prescriptions and/or over-the-counter medication, including dose and frequency
• Information about patient’s medical and surgical history
• Recent test results, x-rays, or relevant records

Patient Forms

• Patient Registration Form (pdf)
• New Patient Questionnaire (pdf)
• Patient Registration Form – Spanish (pdf)
• Authorization for Disclosure (pdf)
• Authorization for Disclosure – Spanish (pdf)
• No Show & Cancellation Policy (pdf)
• No Show & Cancellation Policy – Spanish (pdf)
• Notice of Privacy Practices (pdf)

Patient Portal

For access to our Patient Portal you must be a patient. Please call or office at 239-939-0999 and provide our staff with your email address. Once that information as been obtained, you will receive an email invitation to join our patient portal.

Insurance and Payment Information

Associates in Nephrology is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

Privacy Practices

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.