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Patient Information

First Appointment

How to prepare your New Patient Paperwork before your appointment:

  1. Please click the link below for Premier Neurosurgical Institute’s New Patient Paperwork
  2. DOWNLOAD the PDF file of the Patient Paperwork
  3. You may type in the editable form slots your information to complete the form.
  4. When you are finished, PRINT the paperwork and bring it to your appointment.

Download, Type and Print

If you have any questions or difficulties with the form, please call our office!

 

Ambulatory Surgical Center Appointment

If you have been recommended for a procedure at Premier Ambulatory Surgical Center, please fill out the following paperwork prior to your appointment:

  1. Please click the link below for Premier Ambulatory Surgical Center Patient Paperwork
  2. DOWNLOAD the PDF file of the Patient Paperwork
  3. You may type in the editable form slots your information to complete the form.

When you are finished, PRINT the paperwork and bring it to your appointment.

Download, Type and Print
If you have any questions or difficulties accessing the form, please call our office!

 

General Information

Our Doctors and Staff would like to welcome you to Premier Neurosurgical Institute and Ambulatory Surgical Center. Please take a moment to review some general information about our office.

Location
211 Chicopee Drive
Marietta, GA 30060
Phone
Hours
678-872-8750
8:00 a.m. to 5:00 p.m.
Monday – Friday

 

New Patients

Please arrive 15 minutes early for your first appointment and provide the items below. Also, bring in any previous film, MRIs or studies relating to your visit with you.

Insurance card
Driven License or some form of picture ID
Previous medical records
List of current medications you are taking

Our physicians will want to review the most recent MRI done related to the reason for your visit. In order to provide you with the best treatment plan, a new MRI will be ordered for you if your most recent MRI was done over six months ago. We have on-site MRI imaging service available. When scheduling your first appointment, please let our receptionist know the date of your most recent MRI.

There will be a $100 charge for not showing for your scheduled appointment unless 24 hours notice is given. If you need to change your appointment time, please call 24 hours in advance to reschedule. If your appointment is scheduled on Monday, please call the Friday before by noon to reschedule.

Insurance and Billing

When you arrive for your appointment please provide all insurance cards and information to our office. For payment options we accept cash, check, Visa, Master Card, American Express, and Discover Card. If you have any questions regarding your insurance coverage or payment at Premier NeuroSurgical Institute please call 678.872.8750. Any questions regarding your general insurance coverage can be answered by your insurance company.

Prescriptions

If possible, please call at least three full days before your prescription will deplete, allowing our staff the opportunity to collaborate with your provider. When calling for a prescription refill, please give your name, birthday, daytime phone, the name of the medication and the name and phone number of the pharmacy you utilize.

If you request a refill after business hours or on weekends, your pharmacy will be contacted within two business days. When you are given medication, try to finish the prescription. If you are experiencing side effects or you feel your condition has not improved, call the office or communicate this to your provider on your office visit.

Privacy Policy

In general, the HIPAA privacy rule gives individuals the right to request a restriction on uses and disclosures of their protected health information (PHI). The individual is also provided the right to request confidential communications or that a communication of PHI be made by alternative means, such as sending correspondence to the individual’s office instead of the individual home.

The Privacy Rule generally requires healthcare providers to take reasonable steps to limit the use or disclosure of, and request for PHI to the minimum necessary to accomplish the intended purpose. These provisions do not apply to uses or disclosures made pursuant to an authorization requested by the individual. Healthcare entities must keep records of PHI disclosures. Information provided below, if completed properly will constitute an adequate record.
Download notice of privacy practices

Transportation

If you or a family member are in need of transportation you can contact Novative Transportation Services, the link to their site is www.novativetrans.com and phone number is 770-897-4219. They are a reliable non-emergent Transportation service that services Marietta and surrounding areas.

Note: Uses and disclosures for TPO may be permitted without prior consent in an emergency.

FAQ

Do I need a referral?

Please familiarize yourself with the policies and benefits of your insurance plan prior to your visit, including physician participation and authorization/referral requirements.

What if it is after hours and I need to speak to the doctor?

If an emergency arises after hours or on a weekend, your call will be directed by our answering service. In severe situations or ones in which you are in doubt, go directly to the emergency room or call 911.

Where can I get more information about The Premier Neurosurgical Institute?

We are happy to answer your questions. Please contact us at 678 872 8750.