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Patient Forms

 

In addition to the Yankton office, Dr. Liudahl also practices in four outreach locations in South Dakota.  Please contact the Yankton office at 605-665-6820 for an appointment at any of the outreach locations or if you have questions.

New Patient Forms

New Patient Forms


Please have your insurance information available on the day of your appointment.

If a referral form is required by your insurance, please bring that with you to your appointment.

Word Document Forms

PDF Forms

Patient Information

Patient Information

Patient History

Patient History

Audio History

Audio History

 

Billing & Insurance

Billing & Insurance


We try to provide you with clean accurate bills, therefore you will not receive a statement until after your insurance has processed your charges. When you receive a bill, it means that the amount in the guarantor balance is your responsibility. If you disagree with this amount, please call us immediately so we can review your account.

Billing Questions

We have staff available to assist you with any of your billing questions. Please give us a call at (605)335-1952 or (800)568-4311.