Preparing for your First Appointment

---

INSTRUCTIONS FOR NEW PATIENT

Neuroscience & Rehabilitation Associates accepts new patients by referral from your physician.

If you DO NOT have insurance $200.00 is due at the time of the consultation!
Additional fees may be due if any testing is ordered.

Please do not bring small children to your appointment unless there is someone to sit in the waiting room with them.

A failure to show up for this appointment will result in a $30.00 NO SHOW FEE as we have reserved an hour of the doctor’s time for your appointment.

Please bring this completed paperwork:

New Patient Paperwork

Please bring the following idetification:

• Insurance Cards (Military ID)
• Driver's License or ID

Please bring the following medical information:

• Copies of any MRI or CT scans
• Any other past medical records

If you have any questions or concerns, please contact us.

• 222 N 6th St.
• Manhattan, KS 66502
• Phone: 785-537-9349
• Fax: 785-537-9486