Your First Visit
If this is your first visit to NENA as a patient, it is important that you arrive 30 minutes prior to your appointment time, so that medical history sheets and other necessary forms can be filled out. Please bring your insurance card, photo ID, prior medical scans such as X-ray, CT, or MRI, and any other medical records relevant to your visit. You will be asked to provide a list of any allergies you may have and any prescription and over the counter medications you are taking currently.
If a referral from your primary care provider is required by your insurance, it is important that you contact the assistant for the physician you have been referred to as soon as possible at (978) 687-2321.
All co-pays must be paid at the time of your visit, as mandated by your insurance company as part of their contract.
Registration and Medical History Forms
In order to save you time when you arrive for your visit, we have provided a number of forms online that you can download and print out and complete at home before you arrive at New England Neurological Associates. These forms are provided below as pdf files and as Word documents.
- Assignment of Benefits (pdf)
- Bilingual Registration Form (Word)
- Client Agreement Form (pdf)
- HIPPA Privacy Summary (word)
- HIPPA Summary (pdf)
- Medical Intake Form pdf Medical Intake Form Word format
- NENA Notice of Patient Privacy Practices (word)
- Notice of Privacy Practices (pdf)
- Registration Form English & Spanish (pdf)
Use a pdf reader, like Adobe Acrobat, to view and print these forms. If your computer does not have a pdf reader, you may download the free Adobe Acrobat Reader, at the following address: Adobe Acrobat Reader.