skip to Main Content

We require the following information before or during your initial office visit:

Information about you

  • Name
  • Date of birth
  • Address
  • Phone Number
  • Photo identification
  • Insurance information – please bring your insurance card with you
  • A copy of the order form from your referring physician is required before your study can be performed.

Information about your referring physician

  • Name
  • Address
  • Phone Number
  • Fax Number (if applicable)

Your medical history and records

Please bring:

  • A list of your medications. Also include all vitamins, herbals, or over-the-counter pills or remedies.
  • Discharge summaries from any recent hospital stays (within the past 3 to 5 years).
  • A list of any implanted devices such as pacemakers, implants, or stents.
  • If you have had any diagnostic tests or procedures, such as chest x-rays, CT scans, MRIs, or ultrasounds please obtain the images or films.

Other important information to prepare for your visit:

You are encouraged to bring a family member or friend on the day of your appointment, though it is not necessary unless your procedure requires a driver to take you home.

Downloads

Forms on this page can be used by patients who would like to have their forms filled out before they arrive for their appointment.