New
Patients

FIRST VISIT: FOR NEW PATIENTS

Please bring the following when you come for your first visit:

• All prior medical information including x-rays, scans, MRIs and any accompanying medical reports. (Please bring copies of MRIs and scans on CD.)
• Please complete all appropriate forms prior to your visit in order to expedite your first visit with us.
  1. New Patient Forms
  2. New Patient – Workers Compensation Forms
  3. New Patient – No Fault Forms
  4. New Patient – Scoliosis Forms
  5. New Patient – UnitedHealthcare
  6. New Patient – Blue Cross Blue Shield
  7. Formulario Inicial Del Paciente – New Patient Form/ Spanish Language
• Please bring your health insurance card with you. We will need to scan the card into our computer system.
• If your insurance requires a referral from your primary care physician, please call that physician for the referral number or bring your paper referral.
• If your visit is due to an accident, such as a Workers’ Compensation or No Fault claim, it is imperative that we have all insurance information prior to your appointment.
• All fees and co-payments are due at the time of treatment. Please refer to your insurance plan or contract for information on what charges are covered. Any charges that are not covered are the patient’s responsibility and are payable at the time of service.

Payments are acceptable in cash or by check or credit card.

NOTICE OF PRIVACY PRACTICES

Download the LISS Notice of Privacy Practices

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Section 1557 of the ACA (Affordable Care Act) This notice describes the privacy practices of Long Island Spine Specialists, PC and how Long Island Spine Specialists may use and disclose your protected health information (PHI). Long Island Spine Specialists, P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.