New Patients

Preparing For Your Visit

You’ll want to organize yourself and your information in advance of your office visit. This will help you get clearer on your goals and be better prepared, and also get the most out of your visit. Dr. Pollycove & her staff strive to provide you with a thorough and comprehensive initial visit to help create a well supported health plan and future for you.

Medical Records

You’ll want to order copies of your records well in advance and bring them with you. Dr. Pollycove can gain a lot of insight from your medical records and point out concerns that are specific to your individual health. If you’ve had screening tests or lab work in the past year, make sure to bring copies of the results. Tests of special interest to Dr. Pollycove include a pap smear, a mammogram, and a blood test to evaluate your cholesterol and thyroid levels, and your liver and kidney function. HIPAA requires that copies of tests and/or notes from other physicians and outside facilities can only be released to us with your written consent.

Medications & Supplements

It’s helpful to make a separate list of all medications and supplements you’re taking, including the prescribing doctor or manufacturer, and why you take each one. This will provide Dr. Pollycove with organized information to better assess your health and appropriate treatment plan.

New Patient Forms

Please download and print all of the forms below and complete prior to your appointment. Along with these forms, please remember to bring your insurance card and photo identification to your appointment, as we are required by law to keep this information in your chart.

Download

Patient Forms 2015

Record-Release-From.pdf