Overlake Neurology, Inc., P.S.

Patient Information

Patient Forms

Use the following links to download patient forms. Once open, print the forms and then bring your completed forms to the visit.
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Required forms:

Optional forms:

What to Bring to Your Appointment

Payment and Insurance Information

Dr. Fosmire and Dr. Gorman are providers for Medicare and most major insurance plans. We provide insurance billing for all insurances we are contracted with. Anything not covered by your insurance will be patient responsibility.

We request payment at the time of your appointment for services that are not covered by your insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. If you do not have insurance coverage, we do require payment in full at the time of service. When necessary, our staff will work closely with patients who request an estimate for services. Please note, an estimate is only an estimate and never a guarantee of exact fees. We will also work closely with patients that require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company. Unfortunately, we regret our office does not accept motor vehicle claims or Labor and Industry claims.

Our Office Policy

Our physicians see patients on a referral basis only from another physician. Please contact your primary care provider to initiate a referral to our office. Please have them send your most recent chart notes, labs and any relevant imaging that may be pertinent to your appt. Our physicians require your notes be at our office prior to your appointment. Most insurances do not require a referral to be processed through them, however if you have an insurance that requires this, you are responsible to make sure this is in place prior to your visit to our office. If a referral is required and not processed prior to your appointment, you may be responsible for your visit.

Our office understands your time is valuable and will always make every effort to be respectful of that time. We kindly ask that you extend the same courtesy. If you are unable to keep a scheduled appointment, we ask that you give at least 24 hour notice, to give the opportunity for another patient to have that time. If you are unable to make it, and do not give proper notice our office will charge a $100 "no show" fee for all new patients and 1 hour appointments. If you are a follow up patient, the fee is $25.00. If you are charged a fee, you will be asked to clear the fee before scheduling any further appointments. If you continue not to offer the same courtsey we extend to you, we may no longer be able to offer you further appointments. We understand emergent things come up, and are to hard to control. For this reason we offer an after hours answering service you can reach anytime, day or night. Just call our office number 425.709.7055 and you can be directly connected.

What's New

moving truckWe are moving!
Effective February 23, 2009, we will be at our new location:
Overlake Medical Tower
1135 116th Ave, NE
Suite 200
Bellevue WA 98004
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Dr. Fosmire has been named "Top Doc" in The Seattle Magazine for the last 5 years.

clipboardNew Patients
You can download patient forms from our website and complete them before your appointment.

Go To Patient Forms