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Information Update

Thank you for scheduling an appointment with Dr. Nardine.  Please complete the Patient Information form and send it within two days prior to your first appointment. Include the full name of your insurance company and plan.  The forms can be faxed to 866-332-4290 or emailed to office@nepsychsvcs.com.  We will  copy your insurance card at your first visit.

Patient information     Patient information Update     Credit Card Auth     Fee Policy     Limits of Confidentiality     HIPAA     FAQ – Receiving Messages – iOS     FAQ – Receiving Messages – Android.     Telehealth Consent

Please Note:
**Contact your insurance company to determine if your plan requires prior authorization, and if needed, obtain this authorization from your primary care provider prior to your first appointment.  Your insurance company will not pay for your visit without authorization.

**It is important to know if you have a deductible, and whether or not your deductible has been met.  You will be billed for any deductible applied.

Telehealth Services available when included in your insurance plans’ benefits.

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