Thankyou For Entrusting
Your Care To Us
This page will provide you with all the necessary forms, as well as important information regarding your first visit. Please be sure to read and complete all applicable documents.
In order to expedite your first visit, we request that you arrive 15 minutes prior to your appointment on your initial visit so all necessary paperwork can be processed and you are kept on schedule. If you are unable to keep your appointment, kindly notify us at (631) 498-5632, press 4, or email [email protected] so we may accommodate another patient.
If you have any questions, do not hesitate to contact the office. We look forward to seeing you.
Sincerely
Long Island Spine Specialists, P.C
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 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.
Please complete all appropriate forms prior to your visit in order to expedite your first visit with us.
- New Patient Forms
- New Patient – Workers Compensation Forms
- New Patient – No Fault Forms
- New Patient – Scoliosis Forms
- New Patient – UnitedHealthcare
- New Patient – Blue Cross Blue Shield
- Formulario Inicial Del Paciente – New Patient Form/ Spanish Language
- Formulario De Compensación Trabajadores - Workers Compensation Forms/Spanish Language
- Formulario De No-Fault - No Fault Forms/Spanish Language
- Formulario De Escoliosis - Scoliosis Forms/Spanish Language
Notice of Privacy Practices
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.
Section 1557 of the ACA (Affordable Care Act)
surprise your body
with Extra Care
We focus exclusively on the specific issues relating to the spine. Our medical professionals have years of experience and expertise in all spinal conditions including traumatic injuries and deformities.
Contact Us for An Expert Consultation
Find us near you and start your journey to a pain-free life.
887 Old Country Road,
Suite D
Riverhead, NY 11901
Phone: (631) 837-2359
Fax: (631) 462-2240
763 Larkfield Rd, Second
Floor
Commack, NY, 11725
Phone: (631) 837-2359
Fax: (631) 462-2240
400 Montauk Highway,
Suite 102
West Islip, NY 11795
Phone: (631) 837-2359
Fax: (631) 462-2240
565 Hempstead Turnpike
West Hempstead, NY
11552
Phone: (631) 837-2359
Fax: (631) 462-2240
