Overview

If you are a new patient please download, print and complete the following forms prior to your first appointment. Call our office at (518) 324-4000 if you have questions. If you are unable to complete at home come to your appointment at least 30 minutes early to give yourself time to review.

Important Office Forms

NEW PATIENT QUESTIONNAIRE

Please take your time filling out this comprehensive history questionnaire. Having this form complete makes the most out of your first visit with us

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PRIVACY PRACTICES

Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

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AUTHORIZATION FOR RELEASE OF INFO

Often your insurance carrier will request copies of your records to substantiate payment. Please download, sign and bring this important release form to first visit

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FINANCIAL POLICY

We are doing everything possible to hold down the cost of medical care. The following financial policy is provided to all patients. Please download, sign and bring to your first appointment

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Main Office

Northern Nephrology & Hypertension
52 Tom Miller Road
Plattsburgh, NY 12901
Phone: (518) 324-4000
Fax: (518) 324-4001

Office Hours: Mon-Fri 9AM-5PM

All Rights Reserved © 2019 Northern Nephrology & Hypertension