Patient Registration

Preregistration Information

If you are seeing one of our physicians for the first time, you may have received a packet of forms to be used to complete your registration before your visit. It is important that you complete these forms bring them with you to your office visit.

To cancel or change appointments call the scheduling desk and give your name, your doctor's name and the date and time of your appointment. Please give us 24 hours notice of cancellation if at all possible. There is a $75 charge for NEW patients who do not keep their scheduled appointment.

Emergency patients will be worked into the late morning or late afternoon schedule. You may need to come to the Center and wait to be worked into the schedule.

Online Registration

For patient convenience we have preregistration available online. Follow the link below to and enter your information into the system. Once you have created and updated your account you can then choose your specific Doctor and submit your information.

**Patients being seen for a recheck can also use this online service. There are some forms that are required to be filled out on a yearly basis. By entering your information at you can choose your Doctor, submit your information and it will automatically update these yearly forms. When you arrive at The Center you will be required to verify your information with a signature.

From here follow the steps below in the Registration At The Center section.

NoMoreClipboard puts you in control of your health records. You decide what information goes in, what stays out, and who to share your records with. You can direct your NoMoreClipboard health information to any doctor, clinic or hospital you choose. NoMoreClipboard offers several account options, ranging from a free basic account for relatively healthy individuals to a concierge account for those managing chronic conditions. When you use this service at Fort Wayne Neurological Center there is no charge to submit your information to our Physicians.

Registration At The Center

If this is your first appointment, please plan to arrive on time to complete the registration process. Upon arrival please check in with the receptionist. Give her the patient's name, the physician's name, and the time of your appointment. If you preregistered online please make the front desk aware.

You will be called to the registration desk to verify your preregistration information or have your record updated. Please be prepared to give the following information:

  1. Patient's name, address, phone number and emergency contact
  2. Responsible party information
  3. Insurance information including cards, which will be copied
  4. Employer information for insurance verification
  5. Date of last appointment

You will be called back to see the doctor as soon as an exam room becomes available.

After you have seen the doctor please STOP at the scheduling desk to schedule any tests or return appointments. From there you will be directed to the cashier's desk. Payment is expected at the time of services.Cash, personal checks, Visa, Mastercard, Discover and are accepted. You will be given a copy of an itemized superbill that you should attach to your own insurance form to file with your insurance company.

If you are a member of an HMO Plan, please remember that you must have a referral form from your primary care physician each time that you are seen. If you do not have this authorization form, you will be expected to pay for the services rendered at the time of your visit. If your insurance plan calls for a copayment for the services being provided, the copayment is expected at the time of service.

What's New

Concussion Clinic for Student Athletes

Is it safe for your child to return to their sport? Expert concussion screening and treatment is available every Wednesday from 4-7 p.m.

Learn More

Welcome To Our Website!

Use these pages to learn more about our practice, our physicians, our services, and neurology. We hope you will find these pages helpful and informative as you make health care and medical decisions.