Patient Registration Forms
Whether you are a New Patient or a Returning Patient, our neurologists will ask you to fill out certain medical forms at each visit to help them monitor your condition and progress. These forms include medical history, releases, registration, pain inventory, Cervical Brachial Symptom questionnaire, and other relevant documents.
For a shorter time in the waiting room, please fill out the New Patient Form prior to your appointment with your neurologist to save time on the day of your visit. Otherwise, please arrive 15-20 minutes early to your neurology appointment to complete your registration forms at our office. Surgical patients can view our Pre-operative Instruction before their scheduled surgery.
Our neurologists can assist patients with itemized statements and in some cases, they do accept insurance plans. Please check with your individual insurance plan to confirm that it is accepted by our office. Our office staff will clarify any insurance related questions when you schedule your appointment. You may also need a referral prior to your appointment.
Dr. O’Connor – accepts no insurance plans. Payment is due at the time services are rendered. Itemized statements and necessary reports are provided to assist patients with their own insurance billing.
Dr. Shimizu – accepts Medicare Part B and Cigna insurance only. Otherwise, payment is due at the time services are rendered.