For Neurosurgery Patients and Families

1. Copies of Imaging CDs/Films, Related Test Results, and Office Notes Completed at Outside Facilities: Please bring corresponding CDs/films (MRI, CT, X-ray), related office notes, and test results completed at another facility other than Brigham and Women’s Hospital or Massachusetts General Hospital to help facilitate your care. If you would like to confirm if the physician has access to your imaging results/reports, please contact their office by clicking on the following link: Contact Us
2. Insurance Card and Referral: Please bring your most recent valid insurance card. We will need to make a photocopy of your insurance card for our records even if we have your insurance information on file. If you are a member of an HMO or managed care plan, please call the office of your primary care provider prior to your visit and let them know that you have an appointment with your BWH Neurosurgeon so they can process a referral number for you. Our office must receive your referral prior to your appointment from the office of your primary care provider. Our phone number is 617-732-6600 and our fax number is 617-713-3050. It would be beneficial to you to keep a copy of the referral number for your own record.
3. Co-payment: Your co-payment will be collected at the time of your visit. We accept check and all major credit cards. Please note that as of May 30, 2015, the Department will no longer accept cash payments in clinic.
4. Completed New Patient Intake Form: Please print the appropriate New Patient Intake Form below, and fill the questionnaire for your BWH Neurosurgeon to review during your appointment.
   1. New Patient Intake Form (General)
   2. New Patient Intake Form - Spine
5. Patient Safety Brochure: Please print the Patient Safety Brochure linked below, and bring it with you for your appointment. Please ask your BWH Neurosurgeon any questions you may have regarding patient safety or surgical risks during your appointment.
   1. Patient Safety Brochure

1. Insurance Card and Referral: Please bring your most recent valid insurance card. We will need to make a photocopy of your insurance card for our records even if we have your insurance information on file. If you are a member of an HMO or managed care plan, please call the office of your primary care provider prior to your visit and let them know that you have an appointment with your BWH Neurosurgeon so they can process a referral number for you. Our office must receive your referral prior to your appointment from the office of your primary care provider. Please contact your respective neurosurgeon's office by clicking on the following link: Contact Us. It would be beneficial to you to keep a copy of the referral number for your own record.
2. Co-payment: Your co-payment will be collected at the time of your visit. We accept check and all major credit cards. Please note that as of May 30, 2015, the Department will no longer accept cash payments in clinic.

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