What to Bring to Your Appointment
- Your insurance card
- Your driver's license or photo identification
- Physician referral forms if required by insurance
- 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
- Any recent labs, x-rays, MRIs, CTs, or appropriate records you may have
Before your appointment, please download, print and complete the forms in advance of your first visit.
- Medical History form
- Patient Information form
- Authorization for Disclosure of Protected Health Information
- Office Policy
All dictated notes, labs, and out-patient testing ordered or performed by our physicians, and/or any other pertinent information regarding your treatment is sent to your referring physician(s). If for any reason you would like a copy of your records there is a processing charge for copying of records of $25.00 for the first 20 pages and $.50 per page after. MRI images on CD cost $10.00 per disc, films cost $3.00 per sheet.
Insurance and Payment Information
Neurology Consultants of Dallas is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.
We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.
If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.
Notice of Privacy Practices
State and Federal laws require us to maintain the privacy of your health information and to inform you about our privacy practices by providing you with this Notice of Privacy Practices. Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.