Kidney care starts here!

Call: 518-324-4000

Patient Portal
Office Forms

Download & Prepare

Filling out our intake forms ahead of time makes the most of your first visit. Download, print, complete, and bring them with you — or if you'd rather complete them in person, arrive about 30 minutes early.

Questions before you fill anything out? Call our office at (518) 324-4000 and we'll be happy to help walk you through anything.
Available Forms

Five Forms to Complete Before Your Visit

⭐ Most Important — Start Here

New Patient Questionnaire

The comprehensive history form. Take your time filling this out at home — having it complete makes the most out of your first visit. Includes medical history, current medications, allergies, and family history.

Download PDF Fill Out Online
HIPAA Notice

Privacy Practices

Your Information. Your Rights. Our Responsibilities. This notice describes how your medical information may be used and disclosed, and how you can get access to it.

Download PDF
Records Release

Authorization for Release of Info

Your insurance carrier may request copies of your records to substantiate payment. Please download, sign, and bring this form to your first visit.

Download PDF
Billing

Financial Policy

We're committed to keeping the cost of care manageable. Please review, sign, and bring this policy to your first appointment so we can answer any questions in person.

Download PDF
Telemedicine

TeleKidney Consent

With kidney specialists in short supply across rural upstate NY, telemedicine helps us reach more patients. Sign this consent so you can use TeleKidney services if needed.

Download PDF

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

DOWNLOAD

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.

DOWNLOAD

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

DOWNLOAD

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

DOWNLOAD

TELEMEDICINE CONSENT

With the declining number of kidney specialists nationally superimposed on our rural upstate NY region providing TeleMed Services are critical. Please sign this consent so you can take part if needed.

DOWNLOAD

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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

© 2026 Craig G. Hurwitz, MD — Northern Nephrology & Hypertension