Patient center
Patient Forms
Download and complete required patient forms before your neurology appointment at Charis Neurology.
- Board-certified neurologist and fellowship-trained neuro-oncologist
- On-site MRI, EEG, EMG, and infusion therapy
- Lake Mary care for patients across Central Florida
Forms in English and Spanish
Bring ID and insurance
Arrive prepared
Call with questions
Before your visit
What forms do new neurology patients need?
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What Forms Do New Neurology Patients Need to Complete?
New patients at Charis Neurology are asked to complete a set of patient intake forms before their first appointment. These forms allow our neurologists to review your medical history, medications, prior testing, and insurance information in advance, helping ensure a focused, efficient, and meaningful consultation.
- Completing your forms ahead of time reduces delays and allows for more time to discuss your symptoms, diagnosis, and treatment options during your visit.
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Required Patient Forms
Please review and complete all applicable forms prior to your appointment.
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Notice of Privacy Practices
This document describes how medical information about you may be used and disclosed and explains your rights regarding access to your protected health information. Patients are encouraged to review this notice carefully.
- Download: Notice of Privacy Practices (PDF) Spanish: Aviso de prácticas de privacidad (PDF)
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Authorization for Release of Medical Information
This form allows patients to authorize the disclosure of their medical information to a designated individual, company, agency, or healthcare facility, when applicable.
- Download: Authorization for Release of Medical Information (PDF) Spanish: Autorización De HIPAA Para Divulgar Información Del Paciente (PDF)
Required patient forms
Complete forms before your appointment
Please review and complete all applicable forms prior to your appointment.
01
Notice of Privacy Practices
Describes how medical information may be used and disclosed and explains patient privacy rights.
Download English PDF02
Authorization for Release of Medical Information
Allows patients to authorize disclosure of medical information to a designated person, company, agency, or healthcare facility.
Download English PDF03
Authorization and Consent for Treatment
Provides consent for treatment, communication by phone, email, and text, and acknowledgement of financial responsibility.
Download English PDF04
Preferred Contacts
Optional form to designate preferred contacts for communication related to your care.
Download English PDF05
Financial Policy
Explains patient financial responsibility for medical services provided, regardless of insurance eligibility or coverage determinations.
Download English PDFLanguage services
Meaningful access to care
Charis Neurology is committed to providing meaningful access to care for all patients, including individuals with limited English proficiency. Language assistance services are available at no cost to patients and are provided upon request.
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Language assistance
Please contact our office before your appointment if you need language support or help with patient forms.
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Notice of Nondiscrimination
For additional information, please review the Notice of Nondiscrimination available through Privia.
Prepare for your appointment
How to prepare for your neurology appointment
Preparing ahead allows your provider to focus on understanding your symptoms, diagnosis, and treatment plan.
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Complete forms
Review and complete all required patient forms in advance.
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Bring identification
Bring a valid photo ID and insurance card.
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Medication list
Bring a current list of medications and dosages.
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Prior testing
Bring prior neurological imaging or test results, including MRI, CT, or EEG, if available.
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Arrival timing
Arrive at least 15 minutes early if forms were not reviewed ahead of time.
New Patient Information
Before your first visit
If this is your first visit to Charis Neurology, review scheduling, referrals, and what to expect before your initial consultation. Charis Neurology serves patients across Central Florida, including Sanford, Longwood, Heathrow, Oviedo, Winter Park, and surrounding communities.
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Questions before your visit?
For questions about patient forms or language services, please contact our office prior to your appointment.
Contact usGood to know
Frequently asked questions
Still have a question? Call us at (407) 603-1633. Our team will follow up during business hours.
Do I need to complete forms before my first visit?
Yes. Completing patient forms before your appointment reduces delays and gives your provider more time to focus on your care.
Are forms available in Spanish?
Yes. Several forms are available in Spanish through Privia.
What happens if I do not complete forms before my appointment?
Patients who arrive without completed forms may be asked to arrive early or may experience delays during check-in.
What should I bring?
Bring a photo ID, insurance card, medication list, and any prior imaging or neurological test results, including MRI, CT, or EEG when available.
Can someone else receive my medical information?
Only individuals or organizations you authorize through the release form may receive protected medical information.
Contact us
Questions before your visit?
Our team will follow up during business hours. For urgent concerns, please call us directly.
Call (407) 603-1633 Book Online