What to Bring to Your Appointment
- Your insurance card
- Physician referral forms if required by insurance -It is the patient/parent’s responsibility to arrive with a current referral or appointment will be rescheduled.
- A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
- Pertinent information about your medical and surgical history
Patient Forms
Child New Patient Forms
- New Patient Questionnaire
- HIPAA Form
- Patient Demographics
- Medical Release Form (From outside of office)
- Medical Release Form (From our office)
Adult New Patient Forms
- New Patient Questionnaire
- HIPAA Form
- Patient Demographics
- Medical Release Form (From outside of office)
- Medical Release Form (From our office)
Hospital Instructions
- Epilepsy Monitoring Instructions (child)
- Epilepsy Monitoring Instructions (adult)
- Epilepsy Monitoring Instructions (Sedation)
Patient Portal Instructions
How to Check In For Your Video Visit
Accepted Insurances
- Aetna
- Cigna
- Horizon Blue Cross Blue Shield (HMO, PPO, POS, Traditional, NJ Direct)
- Medicare
- Oxford
- Qualcare
- United Health Care
- Horizon NJ Health
- Aetna Better Health
If you do not see your insurance listed, please contact our office.
Prescription Refills
If you need a prescription refill, please call your doctor’s secretary between 9:00am-4:00pm Monday-Friday. You will need to provide your pharmacy’s name and telephone number, the name of the medication, the dosage and how frequently you take it. All refills will be called to the pharmacy by the end of the business day.
We cannot refill any medication that is not prescribed by one of our physicians.
No Refills can be authorized without a follow up appointment.
ADHD Medication Treatment Protocol
Based on the AACAP Guidelines
If a patient is started on a medication to treat ADD/ADHD at the initial visit, they must follow up within 4-6 weeks with the doctor. (unless otherwise directed)
For subsequent visit, the patient must be seen 2 times in the office within the next 9-month period.
Hospital Affiliations
- Saint Barnabas Medical Center, Livingston NJ
- Clara Mass Hospital, Bellville NJ
- Monmouth Medical Center, West Long Branch NJ
- Community Medical Center, Toms River NJ
Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.