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Neurology Consults, P.C.

Teresa Zyglewska, M.D., Ph.D.

(pronounced: zig-lef-ska or Dr. Z)

What to bring to your appointment

bulletYour insurance card
bulletPhysician referral forms, if required by insurance
bulletA list of current prescription or over-the-counter medications you are taking, including dose and frequency
bulletPertinent information about your medical and surgical history
bulletAny pertinent records, films or test results you may have
bulletAny patient forms you might have filled out in advance (see below)

Patient Information form

If you are a new patient, please link to and print out the new patient forms listed below.  If you need to download Adobe Reader please click on the button below.

Bring the completed forms to your appointment.

bullet Patient Information form

Privacy policy

bullet Patient Release of Medical Information form

The consent form describes how medical information about you may be used and disclosed.  You will need to sign the form, releasing your consent as described.

Payment and Insurance

Teresa Zyglewska, M.D., Ph.D., is a provider for Medicare and most major insurance plans.

We provide insurance billing. Anything not covered by insurance will be your responsibility. 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.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

 

Home Services Patient Info Contact Us