Below are links to the forms and descriptions about the forms that will need to be completed at the Initial Consultation Visit. These forms are also completed every 12 months from initial visit or when demographic information changes. These forms can be printed and completed prior to your appointment.
NOTICE OF PRIVACY PRACTICE (NPP) - This form includes the NPP along with the form that states you received a copy of the notice. On this form you are also able to list any person(s) that you authorize to receive information regarding your care with Neurological Associates. This form does not authorize the release of medical records.
MEDICARE DEMOGRAPHIC FORM - This form is for patients that are covered by Medicare or Medicare replacement plans.
NON MEDICARE DEMOGRAPHIC FORM - This form is for patients that have private health insurance, workers compensation insurance, liability insurance, or private pay.
MINOR DEMOGRAPHIC FORM - This form is for patients that are 17 years old or younger.