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NeuroRehabilitation &<BR>Neuropsychological Services, P.C. NeuroRehabilitation &
Neuropsychological Services, P.C.

Your First Appointment

What to Bring  ||  Patient Forms

What to Bring

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Patient's insurance card
  • List of current prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about patient's medical and surgical history
  • Recent test results, x-rays, or relevant records
  • Completed patient forms

If you have had any previous testing, please bring these results with you.
This may include results from school based tests including the following:
  • Individualized Education Plan
  • Psychological evaluation
  • Educational evaluation
  • Speech language pathology evaluation
  • Occupational therapy evaluation

If you have had any medical evaluations including those from a neurologist or psychiatrist; any MRI, CAT, EEG, PET, SPECT, or any other test results for us to review.

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Patient Forms and Instructions

To assist you in preparing for your upcoming visit with one of our doctors and to reduce waiting time at our office, please read the following questions which direct you to the appropriate forms. You may then print and complete the forms prior to your office visit.

    Is your current injury the result of an automobile accident? Yes

    Is your current injury related to an accident that occurred at work? Yes

    For all other types of injuries or conditions, click here.

[PDF Help]

No Fault Insurance Forms

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Workers' Compensation Insurance Forms

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Forms for Other Types of Injuries and Conditions

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NeuroRehabilitation & Neuropsychological Services, P.C.

1035 Park Boulevard
Suite 2B
Massapequa Park, NY 11762
Tel: 516.799.8599
Fax: 516.799.4054