Washington Square Forms

Please print out, fill out, and bring all of the following forms, along with:

• All insurance cards and any referrals (if necessary)
  
• Any relevant records, for example: Pathology reports, any recent lab results, CT/MRI/ PET and/or x-ray reports.

We would appreciate if you could arrive 15-20 minutes early to your appointment in an effort to gather the appropriate paperwork and have you ready for the doctor at the time of your appointment.  If you have any questions prior to the appointment, please feel free to call us at (215) 829-6088.  Thank you.

In an effort to improve our medical records management, we will be changing to an electronic charting and medical records system. We believe that this system will help up provide more accurate, efficient and safer care for you. All of your patient-identifiable medical information will be kept strictly confidential, although it will be stored electronically at a remote site.