Patient Forms  

Prior to scheduling an initial appointment with RMANJ, all patients must provide medical records specific to their care, as well as other written information. This allows our team to review the information before your visit so that we can make effective use of your time with us. Please complete the following forms and fax them to 973-290-8370 or email them to pservices@rmanj.com at least 1-2 weeks prior to your appointment:
 
RECORD RELEASE FORM (You may use this form to request your records from you gynecologist or an other previous physicians)
 
 
Cancellation Policy
As you know, waiting for an appointment to begin fertility treatment can be stressful, so we ask you to be considerate of other patients who are waiting for their appointment with RMANJ. To ensure every patient is satisfied, here at RMANJ, we have developed guidelines for canceling and rescheduling new patient appointments. Please review the following and call the patient liaison department at 973-656-2089 with any questions:
 
If it becomes necessary for you to cancel your appointment, we require at least 48 hours notice, so that we can contact other patients who may be able to take your scheduled appointment. If you do not contact us, RMANJ can bill you for the missed visit.

 
 
Cancel/Reschedule Policy
If you have cancelled your appointment three times, RMANJ will ask you to complete a Credit Card Authorization Form for payment. This will ensure us of your commitment to your next rescheduled visit. You will be charged for the initial consultation fee and when you come in for your consultation, you will be reimbursed this fee minus your co pay.