Forms

Below are all necessary patient forms that you need to complete prior to your appointment. Please complete each form to the best of your ability.

Please bring your current medication(s) in the original bottle(s) for our doctors to verify the name and dosage. Neurological consultations and new patient evaluations range in price depending on the complexity of the examinations, diagnosis, and treatment options and time involved. All co-pays and deductibles are due at the time of your appointment. Please note that we accept assignment only for Medicare, Medicaid, Workers’ Compensation, and some HMOs. (You may contact us to verify coverage by your plan.)

If your injury is related to an auto or work accident, your auto insurance agent or worker’s compensation adjustor should have made the appointment and furnished our office with all related billing and claims information. If you have any concerns about this process, please contact your agent or adjustor. If there is an attorney involved in your case, please notify the receptionist.

If you have had an MRI, please bring you original films and paper report. You should give the facility where the films were done a 24-hour notice, so they will have the films ready for pick-up.

Please remember to bring your insurance cards and driver’s license for us to copy. Please do not hesitate to call our office if you have any further questions.

Sincerely,
Tallahassee Neurological Clinic
Department of Neurosurgery