Download Patient Forms
Payment and Insurance || Hospital Privileges
What to Bring
You can view and print the necessary patient forms for your appointment by following these easy instructions. In order to view and print the forms, you need to have the Adobe Acrobat ReaderTM, which may already be installed on your computer. If not, you can easily and quickly download a free version of Reader by going to the Adobe Acrobat Reader website.
Registration/Personal History Form
Patients are generally asked to complete a registration/personal history form on their first visit. Click here to view/print the Registration/Personal History Form.
Neurological Services of Orlando is a provider for Medicare and most major insurance plans. We provide insurance billing; anything not covered by insurance will be responsibility of the patient or guardian.
We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.
If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at 407.240.1762, ext. 18. Questions regarding your coverage and benefits should be directed to your employer or insurance company.
Neurological Services of Orlando has admitting privileges at the following hospitals:
Dr. Mark Klafter
Dr. Daniel Jacobs
Dr. Ahmed Sadek
Dr. Navin Verma