Advantage Physical Medicine & Rehabilitation, LLC

If you are a first-time patient to our practice, please read the general instructions below. Then complete the forms below that apply to you and return them via mail (US Postal), fax (845-344-6072) or email (advantagepmr@protonmail.com). 

Please bring the following with you to your appointment:

• Your insurance cards and a referral (if required). Please check with your insurance carrier and/or PCP.
• Prior diagnostic testing results/report (MRI, CT, X-RAY) that is relevant to your current visit/condition.  Radiology facilities may require 24-48 hrs advanced notice to process your request.
• Any co-payment as dictated by your insurance company.

If any of the above information is missing or incomplete, your appointment will likely be delayed or even rescheduled.  We thank you for your cooperation and look forward to seeing you in our office.

Forms:

For ALL patients:

• New Patient registration form
• Financial Policy / Hipaa
• Assignment of Benefits- AOB

For Workers’ Compensation patients, this additional form:

• Workers Compensation Form

For No-Fault patients, these additional forms:

• No Fault NF-3 Form
• No Fault NF-3 Instruction Sheet

Formularios en espanol

Para todas las pacientes:

• Formulario de registro de nuevo paciente
• Politica financiera / HIPAA
• Asignacion de beneficios

Para los pacientes de compensación para trabajadores, este formulario adicional:

• Compensacion de trabajadores

Para pacientes sin culpa, estos formularios adicionales:

• Instrucciones sin culpa (NF-3)
• No Fault NF-3 Form