Pre-registration forms should be filled out prior to your arrival.
- Registration Agreement – English
- Registration Agreement – Spanish
- Patient Information Form
- Past-Medical History Form
- Medication History Form
- Headache Center Registration Form
- Authorization to Release Health Information
- Every effort is made to see you as close to your scheduled appointment time as possible. In order to help us meet this standard, we ask that you arrive at least 30 minutes earlier than your appointment time. This will allow us time to register your pertinent information into our computer system.
- Because it is so important that we always maintain accurate information about you, we confirm specific information such as date of birth, telephone, address and insurance information at each visit. While we know many patients consider this excessive, we find it crucial to have the correct telephone number in order to contact you concerning your health status.
- Please remember to bring your insurance card(s) and driver’s license with you. For your convenience, we do file most insurance plans, but it is extremely important that we have the correct information.
Co-payments, as well as prior balances are collected prior to your visit. This should help minimize the wait in checking out after you have been seen.
- As a courtesy to other patients, please give us a notice of 24 hours if you will not be able to keep your appointment.
We will not accept patients with pending litigation. We ask that you inform our office prior to your first visit if a lawsuit concerning your medical condition is pending.
- Prescription refills may be requested by telephone and at follow up visits. Prescriptions for medications that are new to the patient are written during office visits only and will not be prescribed by telephone.
- Results of studies and lab work are discussed at follow up visits. We will immediately notify patients with medically urgent results. We do not routinely notify patients of normal test results. You may telephone us for test results if necessary.
- Cumberland Neurology Group does not prescribe chronic narcotic medications and does not manage patients on chronic opioids. We will not resume prescriptions for narcotic medications begun by another physician.
- We will be happy to file your insurance for you; however, it is important that you provide us with the correct insurance information. Any change in your name, address or insurance plan should be given to our front office staff upon your arrival to our office. For billing or insurance questions please contact our billing office at (865) 481-0333.
We hope you find this information valuable. If you have any questions about your visit, please feel free to call the office at (865) 481-0333. Additionally, if you experience any problems during your visit, please don’t hesitate to share your concerns. Again, we are pleased you have chosen our office and hope that we can meet your healthcare needs.
Click here to access our secure patient portal for easy health information access.