Forms and Privacy Practices
Below are forms which patients may fill out before coming to visit us, as well as our privacy practices.
Patient Information Form: Basic information needed by us including address, insurance, etc.
Privacy Practices: How medical information may be disclosed and how you can access this information.
If you have any questions, “Ask Vincent”. He is an excellent source of information and will direct you to the appropriate staff member. Vincent@glashowmd.com
Vincent can assist you with:
• Making an appointment
• Messages for Dr. Glashow and all staff
• Helping patients fill out their initial evaluation forms
• Arrange for your MRI
• Collecting medical insurance information from patients
• Assist with prescriptions and pharmacies
• Letters of medical necessity , etc
• Letters to freeze gym memberships
• Contact information/ phone numbers for: