Patient Forms | Sikora Integrative Medicine

Dr. Sikora is NOT A Primary Care Physician.

For New Patients:

You may fill out new patient paper work here. If you choose to fill out paper work in the office, please arrive 30 minutes early to do so.

If you wish to become a patient for pain management, please have a referral sent to us from your primary care physician or other referring physician. If you do not have a referring physician, please bring in or send us any treatment records verifying your condition along with any MRI or other imaging studies done within the past two years.
For medical marijuana, if you have a qualifying condition, please bring in or send us any imaging studies or other physician’s treatment note verifying the qualifying condition.

Records can be emailed to scheduling@sikoramed.com or faxed to us at (772)228-6883.

Please review our notice of Privacy Policies

Patient Forms

Are your services covered by my insurance?

We are in network with Medicare, Cigna, and BlueCross Blue Shield Options.
We do not accept BlueSelect plans. 

We do bill the above insurances for pain management (medication management, joint injections, trigger point injections, and follow-up visits related to your medical condition).

Please note the following is NOT covered by insurance and considered Self Pay.

Medical marijuana evaluation and certification and follow-up appointments.

Regenerative medicine services (stem cells, Platelet Rich Plasma) and Anti-Aging (IV Vitamin Therapy, Bioidentical Hormone Therapy).

Aesthetic services (cosmetic Botox, PRP facial, microneedling, mesotherapy) are also not covered by insurance.

Acupuncture is not covered by Medicare except for 12 visits in 90 days for chronic low back pain. It is your responsibility to check your individual plan for benefits.

If you need financial assistance, We offer M-Link Financial.

Spectracell micronutrient testing is covered by Medicare and some commercial insurances.