Patient Information - Drs. Gouel and Sullivan


Patient FormsWe participate with most major insurance carriers. You can either call us or your insurance company to check! Practice Dynamics, Inc. is the medical billing company that we use.  If you have any questions regarding an invoice, would like to pay an invoice, etc. please call 410.469.4369.

To mail payments, please make your check or money order payable to (include your child's name and the account number on the check):

  • LifeBridge Community Physicians, LLC
  • P.O.Box 62643
  • Baltimore, Maryland 21264-2643

Please remember to bring your insurance card with you to each visit. We accept cash, checks, VISA, MASTERCARD and money orders.

Insurance Referrals

When your insurance requires a referral to a specialist, please allow 24 hours for us to complete this form. All referrals can be faxed to the specialist or picked up. Note that insurance companies do not permit back-dated referrals. If it is an emergency visit, let us know. We will complete the request.

Online Bill Pay

To pay your bill online go to:


Kids playing outsideCall-In-Time

Between 8:30 a.m. and 9 a.m. weekdays, a physician is available to speak with parents regarding a child's problem. They can help direct you on a course of action.

Sick Appointments

Same day appointments can be made for an ill child. We don't schedule these appointments ahead of time as many times the child improves overnight.

Conferences & Consults

We welcome the opportunity to meet with parents regarding their child's development. The physicians schedule conferences at the following times:

  • Dr. Gouel - 5 p.m. on Monday, Tuesday and Thursday
  • Dr. Blotny - 8 a.m. on Monday, Wednesday and Thursday
  • Dr. Sullivan - 8 a.m. on Monday, Tuesday, Wednesday and Friday; 1:30 p.m. on Tuesday and Friday


There will be a $25 charge for appointments per child cancelled without 24 hours notice.

Inclement Weather

We rarely close! However, if we do, we send email notices to keep you informed and up to date on the situation. We will reschedule all visits missed due to closure.

Medication Refills

It's a good idea to have a week's worth of medication left when you call for a refill. Call your pharmacy first to request refills. They will fax us the request for processing. It's much faster to get your refill this way!

Maintenance Medication: Call us to check your child's eligibility for a refill. We can process the pharmacy request more efficiently. Some medications require pre-certification and can take several days. Please provide self-addressed, stamped envelopes for mailing.

School, Camp, Sports & Immunization Forms

We are happy to complete these forms for our patients. However, most school and camp forms require that a well child exam be done within the previous year. If you have not had this exam, you are required to schedule an appointment.  If you have had a physical in the last year just fax, email or bring in the forms and we can complete them for you.   Due to summer vacation volume, please call us as soon as you receive forms to schedule an appointment.  We now have the ability to scan and email your forms back to you!  Send us just the forms that the physician will complete.  We won't need the pages that you the parent are required to complete.

Patient Forms

Visit the patient forms page to download our forms.


We are compliant and committed to maintaining your family's medical information in accordance with Federal Law.


Find Us

Get directions and office hours.

1205 York Road
Suite 18
Timonium, MD, 21093

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Affiliate of LifeBridge Health
LifeBridge Health

1205 York Road, Suite 18
Timonium, MD, 21093