PRISCILLA E. SIERK, D.O., P.A.
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Current Patients

Pay

  • Online Payment - is now available!

Forms

  • Insurance Update - Please let us know if your insurance changes!  Be sure to double check your benefits with your carrier, we strongly suggest using this benefits check form to verify your coverage and avoid surprises.
  • Refill Request - Please initiate all refill request through your pharmacy.  Only use this form if that does not work.  Please note, medication changes will likely require an office visit. Per our office policies, refills take up to 48 hours. Please plan ahead.
  • Release of Information - Authorization to release information, either to, from, or both with others parties.
  • Confidential Document Upload - Need to send us something, this is the form. We will let you know when to use it.
All forms are hosted on a HIPAA compliant medical web site.  Any questions, please call.

Appointment Reminders

Our system will remind you of your appointment as follows -
  • 3 days prior - Email
  • 2 days prior - SMS Text (if allowed) & Phone call.  Please let us know your SMS preference
  • Use the "RevSpring Patient Connect" app on iOS or Android (please enable push notifications)
We do have a 48 hour appointment cancellation policy.  We cannot guarantee reminders will work. Please make a note of your appointment time.
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  • Home
  • Current Patients
  • New Patients
  • Contact
  • PAY/PORTAL