We may need to perform some tests to determine the severity of your condition or to
obtain a diagnosis. When you call, our nurses will obtain some preliminary information
from you to determine next steps.
We may need your records, x-rays or films from your referring doctor.
We may ask you to fax certain information to our Office and bring other information
with you.
Depending on your insurance, you may need a referral from your primary care
physician. Medicare and traditional Blue Cross/Blue Shield patients do not need a
referral. Please contact your referring doctor to obtain authorization, if your carrier
requires it. The authorization can be faxed or mailed to our office at:
Summit Surgical Institute 332 Summit Avenue Hackensack, NJ 07601 Phone: (201) 488-6445 Fax: (201) 488-6441
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Patient Profile Form
To help your first appointment go smoothly, please complete our Patient Profile form ahead of time. Then bring the completed form with you to your first appointment.
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We Look Forward to Serving You!
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Summit Surgical Institute One Sears Drive, 3rd Floor Paramus, NJ 07652 Phone: (201) 265-1588 Fax: (201) 488-6441
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Summit Surgical Institute 410 Lakeville Road, Suite 310 Lake Success, NY 11042 Phone: (516) 233-1952 Fax: (516) 233-1954
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Medical Disclaimer
The information on this web-site or by any links to or from this site is strictly presented for educational and entertainment purposes only. This information is not
a recommendation for a specific treatment plan, product, or course of action or medical or healthcare provider. In addition, this information may become out
of date over time. It is important that you see a healthcare professional for detailed information about medical conditions and treatments. This information is
not intended to be a substitute for the advice of a healthcare professional or a recommendation for any particular treatment plan.
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Office Manager: Rose Nozilo
Office Manager: Rose Nozilo