Neurosurgical Associates, P.C.
About Us
Neurosurgical Associates, P.C.

Click on the name of the form to download the form.

New Patient Forms - If you are a new patient to our office, please print out and complete the following 3 forms. Bring them with you on your first visit to our office to be added to your patient chart.

Patient Admission Form (Contact and insurance information)

Medical History Form Part I (Clinical questionaire regarding the reason for your appointment)

Medical History Form Part II (Clinical questionaire regarding your past medical history)

Privacy Policy Forms - (HIPPA forms)

Notice Of Privacy Practices

Authorization Form (To be completed in order for health information to be disclosed)

Verification Form (To be completed to verify the identity of a person requesting health information)

Request for Access to Protected Health Information (To be completed to obtain access to protected health information)




About Us

Our Physicians

Practice Areas

Patient Education

What's New

New Techniques

Office Policies & Forms

Photo Tour

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Let us know if you have any questions or concerns.

Specializing in Brain and Spinal Surgery

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Neurosurgical Associates, P.C. 1000 Asylum Ave., Suite 3208
Hartford, CT 06105
Fax: (860) 244-3516
Click here for hours and directions to our offices.
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