Sharonville Family Medicine
William P. Sawyer MD
11714 US RTE 42 Cincinnati OH 45241
Medical Home Fee Year 2023
I would like to thank you for your continued support in our effort to offer you personalized care in a comfortable and caring environment that you have become accustomed to in our “medical home”.
- Personal coordination with other physicians and diagnostic test sites to ensure timely care
- Comfortable and quiet office setting and staff who care for and about you
- Offer Home Visits by Dr. Sawyer for those who become home bound
- Provide copies of all your diagnostic tests for your personal records in a timely manner
- Help interpret health insurance coverage and payments
- Offers self-pay options for medical services if we are not in your plan
- Pharmaceutical grade supplements conveniently offered for sale in our office
- Continue to offer phone consults and telehealth
I enjoy serving as your personal physician, coach, and quarterback! I look forward to continuing our relationship.
Sincerely,
Dr. Will Sawyer
Please CHECK your option, SIGN and RETURN this form with your payment.
Individual: $160.00
Family (2 or more): $320.00
To qualify as part of family, children must be under 25 and living at the same address or in college:
______________________________ _____________________________
______________________________ _____________________________
I understand and agree to pay the Annual Medical Home Fee charged by Dr. William Sawyer.
Name: _________________________ Date: ____________
Changed your e-mail? We want to conveniently share information from our office.
E-mail address: _________________________________________
**Remember**, if you do not pay the Medical Home fee by December 31st you need to send a signed, dated release of medical records request that includes the name and address of your new physician plus any balance owed on your account prior to us forwarding your health summary.