The physicians and staff of Regional Surgical Associates, P.A. would like to take this opportunity to welcome you as a new patient and acquaint you with some policies of our practice.

In order to facilitate your time with us to the fullest, we ask that you bring the following information with you at the time of your visit.

• If you are scheduled to see Dr. Goldstein regarding Lap-Band weight loss surgery, you must download, print, and complete THIS FORM and bring it with you to your appointment.  If you do not already have Adobe Acrobat Reader software installed on your computer, which will allow you to view Dr. Goldstein's form, you can download it for free from Adobe's web site by clicking HERE.  If you are unable to download the form, please call our office and we can have the form mailed or faxed to you.

• If you have health insurance, please bring your insurance card(s) with you. Should you belong to an HMO plan (such as Aetna, Amerihealth, etc.), it is your responsibility to bring with you a referral form from your primary care physician. Not having a referral will result in our having to reschedule your visit since these plans will not cover services rendered without the required referral.

• While most insurance plans cover the majority of costs incurred, many also include co-payments and/or deductibles that are the responsibility of the patient. Please be prepared to pay for any of these out-of-pocket expenses at the time of your visit.

• For patients without insurance or whose plans we do no participate with, payment is expected at the time of services unless other arrangements have been made with our billing office staff. For your convenience, their direct telephone number is (856) 596-9737.

• If you have had any films done (x-rays, MRIs, CT scans, etc.), please be sure to bring a copy of those films along with a copy of the report to our office at the time of this visit. You can also ask your primary care physician to fax copies of any reports to our office prior to your visit. Our fax line is (586) 751-3320.

• If you are taking any current medications, please compile a list of them to bring with you at the time of your visit. This list should include current dosages and how many times you take that particular medicine per day. Please also list non prescription medicines you may be taking.

Knowing that a visit to the doctor's office is almost certain to cause some degree of anxiety, we wish to make your time with us as pleasant and productive as possible. If you have any questions at all regarding your treatment, billing policies, etc., please be sure to ask one of our professional staff members who are here to serve you.

Ph: 856-596-7440
Fax: 856-751-3320