SCHEDULING AN APPOINTMENT
At Affiliated Neurology Center we try to arrange an appointment at a time most convenient for you. In urgent cases appointments
can usually be scheduled within 24 hours.
Patients should bring the following documents to the appointment:
· Patient's medical insurance card or, if
___compensation insurance information
· Physician referral forms, if required by insurance and available
· List of medications
taken, information on dosage and frequency
· Information about the patient's medical and/or surgical history
· Medical records and recent X-rays, CT or MRI scans,
Patients can save time in doctor's office by downloading, printing and filling
following forms before the appointment:
Patient Information Form
Personal Injury Questionnaire
Consent to Treat Minor
Authorization to Release Information
Patient Responsibility Form
Please call Affiliated Neurology Center staff with any questions regarding these forms. Also, please read the
HIPAA Notice of Privacy Practices which tells you how we may use and disclose your protected health information.
If you have a medical emergency please dial 911.
Also, if being evaluated by an Emergency Room physician please provide our office contact number. Our Doctor will be paged and will assist with necessary information regarding your condition and treatment.
25982 Pala, Suite 150
Mission Viejo, CA 92691
Tel: (949) 586-5500