First Visit
Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day. Interventional spine procedures are performed at the Blue Bell Surgery Center and will need to be scheduled for a day other than the initial visit. We make every effort to schedule procedures in a timely manner.
Please arrive at least 20 minutes prior to your scheduled appointment time and assist us by providing the following information at the time of your consultation:
- Completed New Patient Intake Form and New Patient History Form
- Signed Consent Form and Notice of Health Information Practices Policy Form
- Your referral slip and any X-rays, MRI Scans or CAT Scans if applicable
- Referring doctor’s name and telephone number
- Your Insurance Cards and a Photo Identification
- A list of medications you are presently taking including the strength and dosing instructions
- If you have medical insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
Please Note: Please have your referring doctor fax to our office your previous medical notes 48 hours prior to your appointment. Our fax number is (267)462-4504.
IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.
Please alert the office if you have a medical condition that may be of concern prior to a procedure (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant/blood thinning therapy, etc.).
Patient Forms
Prior Imaging Studies
If you have had any recent x-rays, MRI’s, CAT Scans or other imaging studies of your neck or back (within 6-months), please request that they be put on a CD from the facility where you had the study done and bring them to our office. Your doctor can go over them with you at your initial office visit.
Referrals and Authorizations
You must obtain a referral from your physician (primary care doctor or other referring doctor) prior to your appointment.
If your insurance company requires authorization for a visit to a specialist you must also obtain this authorization number prior to your visit.