Patient Appointment sheet

3D Mammography with C-View
p(585)442-2190
F(585)758-7092
www.ewbc.com
is the EWBC standard of care
for all patients at all of our offices
Main Office (Brighton): 170 Sawgrass Dr., Rochester, NY 14620
BaTaVia: 203 Summit Street, Batavia, NY 14020
Greece: 3 Saredon Pl., Suite 200, Rochester, NY 14606
GeneseO: 126 Court St., Geneseo, NY 14454
VicTOr: 7375 State Route 96, Suite 100, Victor, NY 14564
Offices of:
Stamatia V. Destounis, M.D., FACR
Posy J. Seifert, D.O.
Patricia A. Somerville, M.D.
Philip F. Murphy, M.D.
Wade C. Hedegard, M.D.
Lisa V. Paulis, M.D.
Alena Levit, M.D.
Account #:
Your appointment is scheduled on:
Date:
Time:
For:
Location:
Please note your aPPOINTMENT LOCATION. (Directions and map on reverse side — or at ewbc.com)
If you are scheduled for a screening mammogram but you or your doctor have found a new lump that did not disappear,
or if an old lump or thickening is getting bigger, please call the office as your appointment will need to be rescheduled.
Payment:
How long will you be here?
payment is expected at time of visit whether you have a copay or
deductible plan. please be aware additional testing is considered
diagnostic and may result in out-of-pocket expenses to you due
to deductibles, co-insurance and/or co-pays. Every insurance policy
is different – please consult with your insurance company to
determine if your diagnostic tests will be covered.
Screening mammogram— not waiting for results (all locations): About 1 hour
Screening mammogram— waiting for results (all locations): No additional
testing required: Currently about 90 minutes. If additional testing is required
(all locations): Your wait time may be up to 3 hours depending on services available.
Screening mammogram & screening ultrasound (all locations):
There will be an additional $20 charge for co-payments and
deductibles not received at time of service.
There will be a $20 charge for appointments canceled with less
than 24 hour notice. If more than two appointments are missed
without prior notice to our office in a two year period, we reserve
the right not to schedule any further appointments. Terms subject
to change without prior notice.
Preparing for your exam:
DeoDorant: Deodorant can be worn during your appointment.
ILLneSS: In consideration of our other patients and staff, if you are
ill or have a contagious condition at the time of your appointment,
please call us to reschedule.
Perfume & gLItter LotIonS: Please refrain from wearing.
About 2 hours
Bone Densitometry scan (Brighton, Geneseo, Greece and Victor):
About 30 minutes
Diagnostic appointment (Brighton & Victor locations only):
3 hours or more
EWBC is going paperless.
Please read before your appt:
1. Go online to portal.ewbc.com
2. Log onto the portal as an existing patient. Select: I would like a portal
account. If you want immediate portal access, choose: text.
3. Click on the tab: MyHealthHistory
4. Enter or update your information
5. Click on the Save button at the very bottom of the form
If you need help, please call 585-442-2190, opt1, opt 2. If you do not have a computer
or an email address, you may complete paperwork at your appointment.
What to bring to your appointment:
ew ver: 4_17
1. Your current insurance card 2. List of your current medications 3. Photo I.D. 4. Any insurance co-payment or deductible.
5. Referral script from your doctor (if needed)
Directions to our Brighton office (main office):
170 Sawgrass Drive | Rochester, NY 14620 | (585) 442-3922
froM the north/WeSt: Travel 390 South to exit 16B (Rt. 15A - East Henrietta Rd.) Turn left onto East Henrietta
Rd. At the third stoplight, turn right onto Westfall Road. Continue for 1/4 mile to the next stoplight, turn right onto
Westfall Road. Continue for 1/4 mile to the next stoplight. Turn right onto Sawgrass Dr. and follow Sawgrass Dr.
around a big curve in the road. EWBC will be on your left.
froM the north/eASt: Travel 590 South to 390 North. Take 390 North to Exit 16 (Rt. 15A - East Henrietta Rd.)
Turn right onto East Henrietta Rd.
At the second stoplight, turn right onto Westfall Road. Continue for 1/4 mile to
Turn right onto Sawgrass Dr. and follow Sawgrass Dr.
the next stoplight. Continue for 1/4 mile to the next stoplight.
around a big curve in the road. EWBC will be on your left.
ONE WAY
WEST BOUND
froM the SoUth/thrUWAY: Take the NYS Thruway to exit 46. Travel 390 North toward the airport. Get off at
Exit 16 (Rt. 15A - East Henrietta Rd.) Please note that there are two exits for East Henrietta Rd. on 390–be sure to take
the second one, Exit 16. Turn right onto East Henrietta Rd. At the second stoplight, turn right onto Westfall Rd.
Turn right onto Sawgrass Dr. and follow Sawgrass Dr. around a big curve
Continue for 1/4 mile to the next stoplight.
in the road. EWBC will be on your left.
Directions to our Geneseo office:
froM north or eAST: Take I-390 S to Geneseo, Exit 8 Turn right onto U.S. 20A W/Lakeville Rd, follow about 5
miles Turn right onto Main St (Route39) and continue through town Turn left onto Court St. (at flashing light) EWBC will
be on the right (126 Court St.) If you go over the bridge, you’ve gone too far.
froM WeSt: Head east on NY-78 S/U.S. 20A E/Big Tree Rd. Slight right onto NY-39 E/U.S. 20A E/Cuylerville Rd.
(2.4 mi) Turn left onto NY-39 E/NY-63 N/U.S. 20A E/Mt Morris Rd. (0.3 mi) Turn left onto NY-63 N/Genesee St.(1.3
mi). Turn right onto Court St. (EWBC is on left at 126 Court St.)
froM BAtAviA AreA: Take NY-63 S Turn left onto Court St. just over the green bridge (over the Genesee River)
EWBC will be on the left (126 Court St.)
Directions to our Greece office:
.
ay Ave
Ridgew
Ridgeway Ave.
3 Saredon Pl. | Suite 200 | Rochester, NY 14606 | (585) 442-3922
From the North/West: Travel 390 South to Exit 23 (Ridgeway Ave.) Turn right on Bellwood and go toward
Ridgeway Ave. Turn left onto Ridgeway Ave and continue to Long Pond Road and make a left, continue over the canal
and turn left at the signal light intersection of Gates Greece/Townline Road and Ingress Park. You will be turning left onto
Ingress Park. 3 Saredon Place (suite 200) is on the left.
Long Pond Road
Saredon Pl.
Spenc
erport
Lyell Road
From the North/East: Travel on 104 West to 390 South Travel 390 South to Exit 23 (Ridgeway Ave.) Turn
right on Bellwood and go toward Ridgeway Ave. Turn left onto Ridgeway Ave and continue to Long Pond Road and
make a left, continue over the canal and turn left at the signal light intersection of Gates Greece/Townline Road and
Ingress Park. You will be turning left onto Ingress Park. 3 Saredon Place (suite 200) is on the left.
Saredon Pl.
Gates Greece
Townline Road
Long Pond Road
Directions for all our locations can be found at ewbc.com
126 Court St. | Geneseo, NY 14454 | (585) 442-3922
From the SoUth: I-390 N to Exit 7, Turn right onto NY-408 N/Mt Morris Geneseo Rd., becomes Route 63/39 North ,
Turn left (at fork) onto NY-63 N/Genesee St. Turn right onto Court St. (EWBC is on the left at 126 Court Street.)
Ingress
Park
Troll
ey Blv
d
Road
Lyell Ave.
From the South/ThruwaY: Take the NYS Thruway to Exit 46 Travel 390 South to Exit 23 (Ridgeway Ave.)
Turn left onto Ridgeway Ave and continue to Long Pond Road and make a left, continue over the canal and turn left at
the signal light intersection of Gates Greece/Townline Road and Ingress Park. You will be turning left onto Ingress Park. 3
Saredon Place (suite 200) is on the left.
Directions to our Victor office:
7375 State Route 96 | Suite 100 | Victor, NY 14564 | (585) 442-3922
From Eastview Mall: (about 2.75 mi.) Take State RT-96 S./Pittsford Victor Rd. heading toward Victor.
right onto Hadley Cr. (just past Fishers Landing Plaza).
From 490 East: Merge onto State RT-96 S/Pittsford Victor Rd via EXIT 29 toward Victor (1.5 miles)
Hadley Cr., just past Fishers Landing Plaza.
Turn
Turn right onto
From Syracuse area /NYS Thruway West: Merge onto I-90 W/NYS Thruway W via EXIT 25A toward Buffalo.
Take I-490, Exit 45 toward Rochester Take the State RT-96 EXIT 29, toward Victor. Turn left onto State RT-96 S/
Pittsford Victor Rd. Turn right onto Hadley Cr., its just past the Fishers Landing Plaza.
From the Village of Victor: Continue west on Main St./State RT-96, about 2 miles (past Rte. 251 and India
House on same side of road). Turn left onto Hadley Cr.
signs for Hospital (H). EWBC is across from
Directions to our Batavia office: Follow
United Memorial Medical Center)
203 Summit Street (on the left) | Batavia, NY 14020 | (585) 442-3922
FROM THE NORTH/ NY-98 & NYS THRUWAY (EXIT 48): Turn left at light onto Oak St., turn left onto Richmond Ave
(becomes North St). Turn left onto Summit St.
FROM Northwest W / NY-63: Travel south toward Batavia and turn left on Park Road.
Ave (becomes North St). Turn left onto Summit St.
FROM THE SOUTH/ NY-98: Follow NY-98 North to city of Batavia.
Turn right onto W Main St. Turn left onto Summit St.
FROM THE SOUTH/ NY-63: Follow NY-63 heading north.
ton
Clin
FROM THE EAST /NY-5: Travel west on NY-5.
Turn right onto Richmond
At the traffic circle, take first exit onto Oak St.
Turn right on Liberty St (becomes Summit St).
Turn right onto Summit St.
FROM THE WEST/ NY-33: Follow NY-33 going east. At the traffic circle, take the 2nd exit onto NY-98/Oak St.
Turn left onto Summit St.
Turn right onto Richmond Ave (becomes North St).
FROM THE WEST/ NY-5 : Follow NY-5 going east, turns into West Main St, then East Main St through Batavia.
left onto Summit St.
Directions for all our locations can be found at ewbc.com
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