How to Make an Appointment

If you are a new patient, please have the following information available to schedule an appointment:

  • Patient’s Full Name
  • Date of Birth
  • Contact Number
  • Home Address
  • Social Security Number
  • Name of Referring Physician
  • Prescription from Referring Physician (If Applicable)
  • All applicable records
  • Insurance information

 

Please print and  fill out the attached PDF forms  in order for your appointment to be secured.  Please fax all documents to 201-678-9189.

Patient Information     

Patient Policy   

Outpatient Consent Form

Payment Policy

 

If you are having a consultation with the physician, all medical records should be brought to your visit with the below Patient History form filled out. 

Patient History Form

 

Contact Us

To schedule an appointment or for further information regarding patient transport or consultations, please call: 551-996-2453

And/Or contact :

Alison Forte, Perinatal RN

Monday - Friday 8:00am - 4:00pm  at 551-996-3360

E-mail:  aforte@hackensackUMC.org

Magdalena Pawlik, APN

Monday - Friday 8:00am - 4:00pm  at 551-996-4938

E-mail:  mpawlik@hackensackUMC.org

For immediate transport of a patient to our facility please call 551-996-4447 (24 hours a day, 7 days a week).

All transports will be accepted in accordance to EMTALA regulations

 
 


best-hospitals-cardiology    high-performing-indicator-heartfailure    high-performing-indicator-heartbypass     HG_Americas_50_Best_Award_Image_2014      HG_Americas_100_Best_Stroke_Care_Award_Image_2014        HG_Americas_100_Best_Pulmonary_Care_Award_Image_2014     red-bulllgbt      tkc_homepagelogo-2
 


Translation service provided by Google. HackensackUMC is not responsible for the accuracy of translation or any other
aspect of service provided by the GoogleTranslate tool. Users should not make medical decisions without first consulting
with their physician.
 
Site Map|Privacy Policy|Media Center
©2016 Hackensack University Medical Center. All rights reserved.
close (X)