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New Patient Information
HELLO and THANK YOU for deciding to become a New Patient.
On your first visit Dr. Rosania will welcome you.
You will then be asked to fill out some forms, which will help us
gain some information about you and your condition. You can download
them here to save yourself time. Please have your printed and
completed forms to expedite your visit. The following forms are in
Adobe Acrobat; they require the free Acrobat
Reader (Reader 6.0 works the best) to
view (If you have to download the Acrobat Reader, click the back
button, when finished, to return to us).
Click on the form you wish to view. It should
just appear on your screen, if not, it may ask you to save it. If it
asks you to save it, save it to a location you will remember, and
open it with you Acrobat Reader. When the form come up click on the
printer icon to print out all pages. After all the pages are printed,
use the back button to return to this page:
NEW PATIENT
FORMS(Click here).
Please read,print, and
fill out all the attached paper work.
AUTHORIZATION
TO RELEASE PATIENT RECORDS
(Click
here only if you were referred by another Dr.)
AUTHORIZATION TO
TREAT A MINOR
(Click here
only if the patient is a minor).
During the visit Dr. Rosania will go over your
health history and perform an examination, testing your reflexes,
your ability to turn and bend as well as other standard orthopedic,
neurological, postural, and physical examinations. X-ray or MRI may,
at times, be ordered to get a full evaluation. The need for them is
considered on a case by case basis. This will give the doctor a
thorough understanding regarding your condition to determine if he
feels chiropractic care may be of benefit to you. Dr. Rosania will
then discuss his findings and make his recommendations for treatment.
If he can not help you and your condition, he will refer you to a
doctor that will be able to help you the most. Nothing will be done
in our office without your consent.
Payment and Insurance
For patients who have little or no chiropractic
insurance coverage, flexible payment programs can be arranged.
We work with some insurance. We also accept auto
accident patients as well. If you are unsure of your coverage, do not
hesitate to call us. Our staff will verify and explain your benefits
before treatment, at no charge. To find out if your insurance covers
chiropractic care, you can call the office at 1-973-768-5100.
Also for your convenience Mastercard, Visa,
Discover, American Express or E-Check is accepted on line through
Paypal- Its Fast, Free, and Secure! (a Paypal account is not required
for this service.)
    
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