Patient Forms, Map and Directions to Brooklyn Office

 

Overview
Your first visit to The Hershman Group's office involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.

Consultation
Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any X-rays if applicable
  • A list of medications you are presently taking
  • If you have medical or dental insurance, bring the necessary completed forms. This will same time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

X-Rays
If your dentist or physician has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.

To fulfill this mission, we are committed to:

  • Listening to those we are privileged to serve.
  • Earn the trust and respect of patients, profession and community.
  • Exceed your expectations.
  • Ensure a creative, challenging and compassionate professional environment.
  • Strive for continuous improvement at all levels.

 

Patient Forms
Please print and fill out these forms so we can expedite your first visit:

This form, Notice of Privacy Practices, presents the information that federal law requires us to give our patients regarding our privacy practices.

Notice of Privacy Practices
Privacy Practices Acknowledgement

Health History
Financial Agreement
Patient Information

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

 


 

What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.

 


 

Driving Directions

 

Oral and MaxilloFacial Surgeon - Brooklyn
2469 65th Street
Brooklyn, NY 11204
718-382-9399