115 Queensbury Dr SW, Huntsville AL 35802
 
 
 
Call Us Today!
256-880-0222
 
 
 
 
 
 

Patient Information in Huntsville, Alabama

 
 

Patient Forms

Please choose a link below based on your insurance plan. Then, print and fill out ALL forms prior to your scheduled appointment. Bring these completed forms to your appointment along with your driver's license or photo ID and medical insurance card.

Forms by Insurance Type

Patient Registration Forms

Medicare Patients Only Registration Forms

Individual Form Downloads

Authorization and Consent for Treatment of a Minor Patient

Permission to Release Medical Information

Authorization to Release Medical Records

 

Scheduling and Cancellations

Dr. Midenberg’s flexible schedule accommodates most current and new patient needs. As a courtesy, if you are not able to keep your appointment please cancel to allow the opportunity for another patient to see the doctor.

What To Bring To Your Appointment

Being well-prepared for your appointment will ensure that Dr. Midenberg has all of the needed information to provide the best possible care for you. Please remember to bring the following items to your appointment:
 
  • Identification Card (Driver’s License)
  • Insurance Card
  • Current List of Any Medications
 
  • Relevant Past Medical Records
  • Referral from Primary Physician
  • New Patient Paperwork
 

Accepted Carriers

Our office accepts most major insurances. Please call us at 256-880-0222 before your first visit to confirm that your insurance is covered.