Appointments
CLICK TO GET FAQs NORWALK OFFICE 148 East Avenue Norwalk, CT 06851 203-853-0003 phone 203-838-5423 fax DANBURY OFFICE 67 Sandpit Road Danbury, CT 06810 203-792-2003 phone 203-792-8193 fax Email This Page		Download your patient forms here. Please print these documents and fill them out and bring them with you for your appointment. New Patient Registration Form Authorization to Release Medical Records For your initial consultation, please bring the following forms and information. 1. Please download and complete the forms below. New Patient Registration Form Authorization to Release Medical Records About Neurological Surgery ABNS Diplomat Certificate 2. Your current insurance card, driver’s license or photo ID 3. Copies of any recent testing done (ie MRI, CT Scan, Xrays: It is important for the doctor to see the images on film or CD) 4. A referral from your primary care provider if required by your insurance company. This is the patient’s responsibility and your appointment may be rescheduled until the referral is in place. 5. Copayment, if required by your insurance company 6. Please read the office policies before your first visit. (add link to Policies) Note: To view these forms you will need the free Adobe Acrobat Reader. If you don't have it, download it now.

Appointments

CLICK TO GET FAQs

NORWALK OFFICE
148 East Avenue
Norwalk, CT 06851
203-853-0003 phone
203-838-5423 fax

DANBURY OFFICE
67 Sandpit Road
Danbury, CT 06810
203-792-2003 phone
203-792-8193 fax

Email This Page

Download your patient forms here. Please print these documents and fill them out and bring them with you for your appointment.

New Patient Registration Form

Authorization to Release Medical Records

For your initial consultation, please bring the following forms and information.
1. Please download and complete the forms below.

New Patient Registration Form
Authorization to Release Medical Records
About Neurological Surgery
ABNS Diplomat Certificate

2. Your current insurance card, driver’s license or photo ID
3. Copies of any recent testing done (ie MRI, CT Scan, Xrays: It is important for the doctor to see the images on film or CD)
4. A referral from your primary care provider if required by your insurance company. This is the patient’s responsibility and your appointment may be rescheduled until the referral is in place.
5. Copayment, if required by your insurance company
6. Please read the office policies before your first visit. (add link to Policies)

Note: To view these forms you will need the free Adobe Acrobat Reader.
If you don't have it, download it now.