THANK YOU 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 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) 462-BACK (2225), press 4, or email appointments@lispine.com 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. Staff

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 forms prior to your visit in order to expedite your first visit with us.
  • 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.
New Patients, Long Island Spine Specialists

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.

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