Appointments

CLICK TO GET FAQs

bulletNORWALK OFFICE

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

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

Email This Page




  For your initial consultation, please bring the following forms and information.

1. Please download and complete the forms below.

New Patient Registration Form
bullet Authorization to Release Medical Records
bullet Written Acknowlegement of Receipt of HIPAA Policies

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.

 

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





Copyright © 2007, Neurosurgical Associates of SW CT
Site Design by Swarm Interactive