New Patient Forms

Please download all the documents below, print out, complete and bring the forms to your appointment. Additionally, please bring your current insurance card and a photo ID to your first appointment.

New Patient Registration Forms

Medical History Questionnaire

Existing Patient Forms

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.

Existing Patient Registration Packet

Optional Forms

Medical Record Release Form

Consent to Communicate

Associated Brochure Downloads for Your Reference

Patient Rights and Responsibilities (Spanish)
HIPAA Notice of Privacy Practices (Spanish)
Partnership for Safety (Spanish)


We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit Northside Neurology. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.