GETTING STARTED

NEW PATIENT FORMS

In order to make your visit as quick and easy as possible, please fill out and return the required forms prior to your initial appointment.  If you need any help, please contact one of our specialist at 516.355.0111 or email info@spinesurgeon-nyc.com

Preparing for your Office Visit

In addition to completing the forms, please note that we will require the following information for your first visit:

 

  • Driver’s license or other valid government-issued photo identification
  • Insurance information
  • Prior X-Rays, MRI Films, CT Scans, or EMG (please bring the films or CD-ROM containing the images with the paper report)
  • Any pertinent medical history such as lab results

Please note: by law, minors must be accompanied by a parent or guardian.

 

We Look Forward to Seeing You

Please arrive at least 15 minutes early if you have not yet filled out these forms. If you have completed forms with you, you only need to check in with the reception desk 5 minutes before your scheduled appointment.
Thank you for your assistance completing this information. We look forward to seeing you on the day of your appointment!

NEW PATIENT FORMS

INDIVIDUAL FORMS

Medical Records Instructions

Please Fax 516-355-5457 or mail completed form to 2001 Marcus Ave Suite W170 Lake Success, NY 11042.

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