Schedule: M - F: 7:00am - 9:00pm | S & S: 8:00am - 5:00pm
(201) 857-8400

Patient Registration

Please follow our simple patient registration process prior to your visit with us. If you have any questions, please feel free to ask one of our receptionists for assistance.

Step 1

Please reserve your spot at our urgent care by clicking the button to the right. All reservations can be made for any and all services our urgent care provides.

Please note: Our reserve your spot is an estimated time that you will be seen once your registration has been completed. Please note patients with a critical conditions may be seen ahead of you and we take all walk-in patients as well.

Step 2

Fill out our online patient registration form. Click the link to the right to complete this process. This is to ensure a smooth registration process for all of our patients and to gather the necessary information required for your visit.

Step 3

Your patient paperwork can be filled out ahead of time by using the links below to access our patient registration and patient history forms. Please know there is no need for you to do this as we have all forms available in-house for you, but if you’d like to fill them out ahead of time you are more than welcome.

Patient Registration Form

Health History Form

Step 4

Please be sure to bring or have the following pieces of information with you prior to your visit with us:
Driver’s license or photo ID
Insurance information
Payment for copay or self pay
List of medications, allergies, past surgeries
Parental Authorization Form (for minor without parent present)
If you insurance has a deductible or coinsurance, you will be sent a bill for the adjusted charges for the services rendered

For Current Patient:
If your insurance has changed, you will need to present your new card for verification.
If it has been some time since you last visited our facility, you may need to fill out some forms and present a current photo ID.

If you are unsure of your coverage specifics, please contact your insurance carrier directly for information regarding your visit and network benefits.

The Doctors’ Office Urgent Care of Midland Park
85 Godwin Avenue
Midland Park, NJ 07432
Phone:(201) 857-8400

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