New Patient Information
Suggestions Prior to Initial Consultation & Procedures
All new patients are required to fill out forms which enable our practice to efficiently address patient correspondence, billing and financial services. The information in this packet includes:
- Welcome Letter
- Patient’s personal and insurance information
- A copy of our financial policy
- Signature consent allowing us to use and disclose health and billing information.
- You may print and fill out the Registration Packet prior to your visit.
- You may download and print "About Our Practice" notice here.
- Notice of Privacy Practices (pdf)
- HIPAA Patient Acknowledgement Form (pdf)
- HIPAA Information on Columbia University Medical Center Website
- *Please bring your insurance card(s) and referral (if required by your plan) with you to your appointment.*
- If you need to request that your medical records be released, you may download and print the Authorization form.
If you are scheduled to have a procedure:
In addition to the Registration Packet, we also ask that you fill out two questionnaires that pertain to your scheduled procedure(s). You will find them under the Procedure Instructions tab. Please submit these questionnaires along with the Registration Packet preferably ten (10) days prior to the scheduled date. Thank you in advance for your cooperation.