Neurosurgical Associates PC
800 St. Vincent's Drive Suite 700
Birmingham, AL 35205
205.933.8981

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Patient Forms

One of our staff members will contact you prior to your appointment so you may complete your pre-registration forms through our Secure Phreesia Intake Application. Once your pre-registration is completed all we ask that you bring is your Driver’s License, Insurance Cards, a list of your current medications and any outside diagnostic imaging.


GET STARTED TODAY

Visit requestmanager.healthmark-group.com OR Scan the above QR code.

CONTACT HEALTHMARK GROUP

Call: 800-659-4035
Email: [email protected]
Hours: Mon – Fri, 8AM – 5PM CST
Status updates are sent via email and you will be notified once your records are ready for download.

It is an approximately 3 to 5 business day wait on ALL medical records requests.
Medical records requests are processed in the order they are received.

REQUIREMENTS

Ages 18 or older MUST SIGN THE FORM.
Under 18, Legal guardian must sign for the patient.
Form must be filled out completely. Provide an accurate fax number or an accurate address.