(including Former TCI Patients)
We define as “established patients” whoever has already seen Dr. Bolognese in the past.
Prior to your Appointment
COVID-19 INSTRUCTIONS - PLEASE FOLLOW THESE INSTRUCTIONS BELOW TO COMPLETE AND MAIL APPROPRIATE DOCUMENTS
* EMAIL TO MS. PENDERGAST AT email@example.com
Established patients should follow these steps:
• Download and fill out the Established Patient Form (please return in word document -do not convert to pdf)
• Download and fill out the Patient Intake Form (please provide a copy of the insurance card - both sides)
• Download and fill out the Terms and Agreements Form
• Download and fill out the Privacy Statement Form
• Download and fill out the Assignment of Payment of Insurance Benefits and Authorization for Release of Information
• Download and complete Patient Consent Form
• Download and fill out the Release Form
• Please fill out the forms electronically and email them to Irene at IPendergast@NSPC.com
• Please mail CD-ROM’s of your relevant neuroimaging (MRI’s, etc.) and reports to the address listed below.
We will then get back to you to coordinate the date and time for your appointment.
Prior to the Visit
In order to get the most from your follow-up, you should obtain a new set of neuroimaging prior to the visit, covering the anatomical area in question, bringing a CD-ROM of these studies with you to the Center.
If you prefer taking advantage of our regional imaging facilities, let us know and we will book the needed imaging for you, to take place prior to the visit, during the same trip.
In the near future, the transmission of clinical information will take place via a HIPAA-compliant cloud-based software platform. We will make an announcement on this website when this future development will become available.
The fees are the same for patients with accepted insurance and for those making cash payments.