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Patient Information


Telehealth appointments are now available!

To make an appointment, please call 954-262-2850As of October 1, 2016, the INIM will no longer accept private insurance and all patients are required to pay for their visit at the time of service. If the patient has insurance, the patient will be responsible for submitting the paid invoice of the visit to their insurance company for any reimbursement.

Please plan to arrive 30 minutes before your appointment to allow for time to complete any necessary paperwork. For new patients, we ask that you complete the New Patient Form and Online Consent Forms before your first appointment. Established patients should complete the Established Patient Form and Online Consent Forms. You will need to complete the patient and online consent forms before your visit in person, by phone consult or by telehealth as directed by the INIM front desk staff. 

Please bring the following with you to every appointment:

  • Your personal photo identification.
  • Acceptable form of payment (We accept checks, American Express, Visa, and Mastercard).
  • A list of symptoms or problems you have been experiencing, including how long you have had it/them and how you are affected.
  • A list of current prescription and non-prescription medications, vitamins, dietary supplements, or herbs you are taking, including the frequency and dosage.
  • A list of questions you would like to discuss with the physicians.
  • A copy of prior medical records from your previous physician or other health care provider.

If you see other physicians in between your visits, bring information from those appointments with you, including a list of prescription medications, test results, and prescribed treatments.

If you must cancel an appointment, please call at least 24 hours in advance. 


Established Patient

In order to provide you with the highest standard of care, all patients must complete the following form before each visit:

Established Patient Form
Online Patient Consent Forms
Functional Capacity Scale
Activity Log


Opening Encrypted Emails

In our effort to ensure the security and integrity of our email environment, we encrypt all outbound email messages containing sensitive data. Follow the link below for directions on how to open an encrypted email. 

Opening Encrypted Emails


New Patient

Please complete the following forms before your initial physician visit. Having the opportunity to rest during or in between completing the forms will assist in making your experience with our office pleasant.

Also, please keep a log of your blood pressure and pulse for seven (7) days before your appointment day. For each day, we need a reading first thing in the morning while you're still lying down. Then, take a second reading about 10 minutes after you've been up and moving around. Record a third reading during the day, if you have a "crash" period that same day. Remember to include both pulse and blood pressure. Please bring this information with you to the appointment.

New Patient Form
Online Patient Consent Forms


Medications & Prescription Refills

Please bring a list of any medications, over the counter supplements, etc. you are taking and report any adverse side effects.

Refills can be requested by calling (954)-NSU-CARE/ (954) 678-2273 and providing us with the name and phone number of your preferred pharmacy. Please allow three to four business days for us to process your refill request. Do not wait until you are completely out or have only a few days worth of medication to request a refill. Some medication requests will require a prior authorization from your insurance company or may require a visit to our office.


Medical Records & Labs

If you are a new patient, you will need to complete a medical records release form to have your records transferred from your previous physicians. Please complete the form as soon as you join the institute so that your doctor will have your complete medical history. You may download the medical records release form below, complete it, and fax or mail it to your previous physician's office.

If your physician needs your prior medical records, or any test results, please provide our staff with the location and address where the records can be requested. Your written authorization is required for each facility, physician, imaging center, or other provider who will be providing records to us.

Medical Records Release Form



The Institute for Neuro-Immune Medicine is a self-pay clinic. As of October 1, 2016, the INIM no longer accepts private insurance and all patients are required to pay for their visit at the time of service. If the patient has insurance, the patient will be responsible for submitting the paid invoice of the visit to their insurance company for any reimbursement

The patient services that you receive from our office is highly specialized and our fees reflect the training and experience of the physician or healthcare provider, in addition to, the length of the physician visit.

We accept checks, Visa, MasterCard, and American Express. There will be a $25 fee assessed for checks that are returned unpaid.

Please notify our office at 954-262-2850 of other information changes.


Your Visit

Please plan on a 2 hour initial physician visit, and 1 ½ hour return physician visit. During your visit, you may have a variety of diagnostic and laboratory testing performed. In order for your physician visit to be efficient and allow you to get the most out of your visit, bring a list of questions and go over it with your physician.

We recommend that the following questions be asked:

  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?

We also suggest that you:

  • Complete the required forms listed on our webpage, New Patient or Established Patient Form, before your physician visit.
  • Know your family's medical history.
  • Get laboratory tests or procedures done in advance so your physician has the results.
  • Make sure your physician is aware of any changes in your family's medical history.
  • Bring copies of your medical records, if a new patient, or bring any medical records, i.e. emergency room/urgent care records, or specialist records, if seen since your last physician visit
  • Bring your spouse, family member or a friend to ask questions and provide support if you are nervous about your appointment.

Most importantly, speak up. Any opinions, concerns or anxieties you have about your condition or treatment may influence your course of treatment. Be sure to let your physician know about them.


After Hours Care

Although we strive to provide the best level of care possible, please be advised that the institute is not yet able to provide after hours care. If you have an emergency, please dial 911 and follow up with your doctor during normal business hours. 

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