For Patients

Getting Ready for Your Visit

Before your appointment with us, quickly and conveniently access patient forms from our practice.

To view the forms listed below, you will need to download Adobe Reader. Please bring your completed forms with you to our office at the time of your visit.

What to bring to your visit

New patients or existing patients updating information download and complete the forms below and bring to your next visit.

• Your Insurance card(s)
• Photo ID
• A list of your current medications
• Results of your most recent blood work
• Information on what treatments you’ve received and medications you take
• Medical records from prior visits that you think would be helpful
• Referral from your primary physician if required
• Any questions you may have for your physician about health concerns

Patient Forms

• Authorize Record Release to/from Heart & Vascular Associates of Northern Jersey, PA
• Privacy Practices
• Consent for Treatment at Heart & Vascular Associates of Northern Jersey, PA
• Patient Registration
• Register Emergency Contacts
• Notice of Privacy Practices

Formularios para Pacientes en Español

• Consentimiento para el Tratamiento
• Formulario de Informacion del Paciente

Medical Records Forms

• Release Information to/from HVA Medical Group

Insurance & Billing

We participate with most local and many national insurance plans. However, it is your responsibility to obtain a referral from your primary doctor if required and to understand whether your insurance has limits on the doctors you can see or the services you can receive.

If you provide complete and accurate information about your insurance, we will submit claims to your insurance carrier and receive payments for services. Depending on your insurance coverage, you may be responsible for co-payments, co-insurance, or other deductible amounts.