Home
Services
Patient Info
Contact Info
Our Physician
Links
Glossary

→ Board Certified in Neurology

→ Diplomate of American Association of Neuromuscular
     and Electrodiagnostic Medicine (AANEM)

→ Member of American Academy of Sleep Medicine (AASM)

---

Patient Information

What to Bring to the Appointment Insurance and Payment Information Medical History Form

What to Bring to the Appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history
• Any recent x-rays or appropriate records you may have

Insurance and Payment Information

J. Greg Zoltani, M.D., is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Medical History Form

Please print out and complete this medical history form prior to your appointment. Bring it with you to the office on the day of your appointment.

• Medical History Form

[printable page troubleshooting]