PATIENT FORMS & OTHER INFORMATION

 

  • 1

    Dont you hate waiting in doctors office and filling long forms? we do too!

  • 2

    Please download relevant patient intake forms by clicking on link below, complete them in the convenience of your home and bring them with you at the time of your appointment or fax them to (888) 561-3002, even before your appointment.

  • 3

    If you can bring completed forms with you, we will try our best to keep your wait time from none to minimum.

  • 4

    Patient privacy notice is not needed for visit and are onsite only for reference.

  • 5

    Similarly medical information release forms generally are not required unless you want us to get or transfer your information from to other medical office.

  • 6

    Please bring your insurance card and a photo ID with you.

  • 7

    Medical patients should check with their insurance if referral from your primary care doctor is required to see a specialist.

  • 8

    If you need PCP referral please call your PCP office as soon as possible & ask to issue and fax a referral for Dr. Habib, NPI # 1851556286. Our fax # is (888) 561-3002.

  • 9

    We charge now show and late cancellation fees, to avoid them, please call our office at least 48 hours in advance to cancel or reschedule your appointment if you can not keep your scheduled appointment.

NEW PATIENT FORMS

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