Appointment Request

PLEASE READ CAREFULLY AND COMPLETELY: This form is to request an appointment for either an EXISTING/ CURRENT or NEW patient. It is imperative that you GIVE a BRIEF description for the reason of your appointment request. This will allow me to determine if the reason for your appointment request is within my professional ability and scope of practice. Please allow up to 48 hours (72 hours weekends and holidays) for any online confirmation of availability. PLEASE BE ADVISED: All perspective NEW patient appointment requests are limited, therefore such appointments will ALWAYS be entertained and if scheduled, solely by Dr. Schlesinger on the most immediate NEW patient availability basis (DATE AND TIME) between the hours of 8:15 A.M. thru 3:30 P.M. Appointments for an EXISTING/ CURRENT patient may be requested BETWEEN the hours of 8:15 A.M. and 4:15 P.M. on any available day. PLEASE NOTE: For a perspective NEW patient, before any initial office visit and/ or consultation will be offered, any insurance coverage specifically for Chiropractic services MUST be determined. Therefore, please e-mail a copy of the front of your insurance ID card as well as your date of birth at the time of this request to determine your specific Chiropractic benefit. IMPORTANT, if you are a dependent and not the policy holder, you must also submit the name and date of birth of the policy holder. Once again, a NEW patient ON-LINE appointment request will NOT be entertained or considered if any of the foregoing is not submitted at the time of your appointment request. If you are seeking a NEW patient appointment without insurance coverage i.e. SELF-PAY, please indicate so at the time of your request. If you prefer, any appointment requests may also be made by contacting the office directly by telephone at 201-488-5366 Monday thru Friday (8:15 A.M.-4:30 P.M.). Thanks in advance, Dr. Jeffrey Schlesinger