Contact

Prepare for a Visit

Please keep in mind that due to the Covid-19 crisis, some of the instructions below may have changed. The staff member who gives you your appointment will be able to inform you on current procedures.  

How to prepare for:

For any kind of visit please bring the following:
• Insurance card.
• Referral, if necessary.
• All previous records, including all testing, CDs, films and any information you may feel important.
• Choose from the list below for which kind of office visit you are coming in.  Please print, fill out and bring in on the day of your appointment or fax (914-428-9282) the appropriate forms listed below. That will save time and will allow the doctor to have all the information at the time of the visit.
• Cancellation policy: please, give 24 hours notice. That will allow other patients in need to be seen.

Notices for patients:

• Notice of Health Information Privacy Practices

Forms to print:

• Initial visit/Second Opinion/Out of state or International consultations:
NJ:  English / Español
NY: English / Español

• Routine EEG: English / Español 

• Ambulatory EEG without video: English / Español 

• Ambulatory EEG with video: English / Español 

• Video-EEG (admission): English / Español 

• Neuropsychological testing
For Adults: English / Español
For Children: English / Español

• Release records FROM Northeast Regional Epilepsy Group: English

• Release records TO Northeast Regional Epilepsy Group: English

• Consent for Telemedicine Services:
NJ:
English / Español
NY:
English / Español