Patient Forms
Prior to your initial appointment with The Spine Hospital, all patients must conduct a medical phone screening and provide all medical records specific to their care to our office. During this time, our Spine Hospital nursing team along with Dr. Lenke will review the information obtained to ensure that you (the patient) are seeing the appropriate surgeon for your needs. The following information, if available, will be needed for the screening process:
- Patient’s medical and surgical history
- Office notes, if seen by other spine doctors
- Operatives notes of past spine surgeries
- Spine x-rays within the last 6 months on CD
To view the forms listed below, you may need Adobe Reader®. Adobe Reader can be downloaded at https://get.adobe.com/reader/ Once granted a new patient appointment, please bring your completed forms with you to our office at the time of your visit. In addition, please bring the following:
- Patient’s I.D and insurance card
- Up-to-date list of prescribed medication and/or over-the-counter medication (Please include dosage)
- CD of MRI and/or CT of spine within the last 6 months
If you have any questions/concerns prior to your visit, please do not hesitate to contact our office at 212.932.5100.
Please click the titles below to download the form you need:
For additional information on making an appointment or for contact information, follow this link.
