Patient             
Information  

Patient Info

Our immediate goal at Montvale Health Associates is to get you back on your way to better health.

To do this, we first need you to provide us with certain personal information so we can better diagnose and treat your current condition.

Please click on the Office Forms link on the left side of this page to have access to all of our forms.

Here you can click to open the designated form, print it on your computer, and fill it out prior to your office visit. You can either fax it back to us or simply bring it in on your first visit to our facility. This will greatly reduce your waiting time and help us better assist you when you arrive.

Please Note: The downloadable files for printing are in Portable Document Format (PDF). If you do not have PDF reader software installed on your computer you can download one free by clicking on the “Get Adobe Reader” icon above the forms.


Insurance Information

As a multidisciplinary facility with a wide variety of health care providers, there is a variation in the provisions of each individual patient’s insurance plan. Patients are advised to request verification of their insurance coverage from us, which we will do without obligation. Your insurance plan is an agreement between you and your insurance carrier. We are not party to that contract. You are responsible to know your policy. However, we will assist in any way we can to obtain information from your insurance plan regarding coverage, co-pay or co-insurance obligations and deductible obligations so that you can make an informed decision regarding your care.

For additional information please ask to speak to one of our insurance specialists at
201-391-8282.

Appointment

Request an Appointment

Diagnostic

Diagnostic Testing

Office Forms*adobe

*Please call our front desk to confirm which forms you will need to complete: 201-730-4044.

Neuropathy
Neuropathy Intake Forms

Chiropractic/Physical Therapy
Chiropractic/Physical Therapy New Patient Intake Forms
Auto Accident Form (only if applicable)

Massage Therapy
Massage Therapy New Patient Intake Forms

Pain Management Forms (Dr. Gamburg)
New Patient Intake Form
Aesthetic Intake Form

Women’s Wellness Center (Dr. Parnes)
Women’s Wellness Center New Patient Intake Forms

Hand Surgery Forms (Dr. Ugras)
New Patient Packets

Sport Podiatry Forms (Dr. Harris)
New Patient Paper work

Informed Females (Dr. Fricke/Christine Okezie)
Dr. Fricke Patient Form
Nutritionist Form

Acupuncture (Dr. Lambert)
Acupuncture New Patient Intake Forms

Vein Treatment Center (Dr. Geuder)
Vein Treatment Center New Patient Intake Form

Sleep disorder/ENT/Allergy (Dr. Berson)
New Patient Intake Forms
Sleep Study Questionaire

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