What to Bring to Your Appointment
- Your insurance card
- A list of current prescription and over-the-counter medications you are taking, including dose and frequency
- Pertinent information about your medical or surgical history
* Important: Do not print forms double sided.
- New Patient Forms (Male)
- New Patient Forms (Female)
- Medication List
- Medical Record Release (from UGPA)
- Medical Record Release (to UGPA)
- Third Party Release Authorization
- Slide Release Authorization
For the comfort of patients in our diverse community, medical care is available in Spanish, Vietnamese, Tagalog, and English.
- The Valley Hospital
- Hackensack University Medical Center (HUMC ) at Pascack Valley