New Patient Appointments

To request a consultation with a member of Neurosurgical Associates, LLC please fill out the following form. As a specialty center, we accept new patients only after an initial work up, including MRI, has been done by your primary care or family physician. An MRI done within the past 6 months must be reviewed by the neurosurgeon in order to determine if a neurosurgical consultation is warranted. We will contact you directly within one week to let you know if an appointment can be scheduled

• MRI Check-in Form (PDF)
  

Missed Appointment Fee

Due to the high number of patients requesting appointments, waiting times can be long. No-show appointments have a significant negative impact on our practice and the healthcare we provide to our patients, potentially jeopardizes the health of the “no-showing” patient, and is unfair to other patients that would have taken the appointment slot. Because of this, our office has a low tolerance for missed appointments and you will be charged a no show fee of $100. Below is our policy for patients who do not show up for their appointments.

You are a "No Show" if you:

• Miss an appointment without telling us.

• Miss an appointment with less than 2 business days of advance notice.

• Miss an appointment because you have arrived late to the appointment and cannot be seen by the provider on the same day.

If you are unable to keep your appointment, please notify our office at least 2 business days prior to the appointment. This allows enough time to reschedule the appointment time. Please call to cancel or reschedule your appointment by calling our office at 801-507-9555, if after hours leave a message or use myhealthrecord.com to send a message through the patient portal. A no show fee of $100 will not be submitted to insurance. It is your responsibility and must be paid in full prior to scheduling your next appointment. We appreciate being able to care for you. We understand that you may at times need to cancel or reschedule an appointment due to emergencies or other unexpected issues, in these instances, the fee may be waived

New Patient Paperwork

The following paperwork must be completed prior to your first visit with Neurosurgical Associates, LLC. Please complete and bring the following forms with you on the date of your visit. Please contact us at 801-507-9555 if you have any questions or require assistance with the paperwork.

• New Patient Letter - Murray Office (PDF)

• Map to Murray Office (PDF)

• New Patient Letter - Park City Office (PDF)

• Map to Park City Office (PDF)

• Map to St. Mark’s Office (PDF)

• Privacy Notice Policy (PDF)

• Payment Policy Notice (PDF)