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Sall Myers Patient Forms

Accident Patient Forms

Before your first visit, please be sure to bring the following:

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  • Photo Identification (preferably drivers license)

  • Social Security Card

  • Insurance Identification Card

  • Insurance Declaration page (outlining the tort threshold and type of coverage)

  • Police Report

  • Health Insurance (if applicable), we do not participate with any health insurance providers however if there is out of network benefits, as a courtesy to the patient we will balance bill the deductible and co-pay not covered by the motor vehicle insurance.

  • If you are on medication the doctor needs to know. (List of medications)

  • If you are not the insured the insurance carriers now require proof of address before the motor vehicle accident.

  • Please also bring the below forms.

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Below are the forms you will need to bring in (Click to download):

Our New Jersey offices are located in Elmwood Park, NJ, Passaic, NJ,  Paterson NJ, New Brunswick, NJ, Irvington NJ, Union City, NJ, Parsippany, NJ, and Union, NJ.

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New Treating Patient Form

This form is specifically monitored for new patient appointment requests.

For all other inquiries, please contact us directly at 973-279-2323.Thank you for your understanding.

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New Patients & Motor Vehicle Accidents: 1-866-609-4448

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Sall Myers Medical Associates maintains this website as a service to our customers and the internet community. This website has been designed to provide general information about Sall Myers Medical Associates, its services, and its locations. The pages within this site are not intended to provide medical advice, nor do they provide instruction on the appropriate use of products produced or supplied by our customers, their affiliates, related companies, or their licensors or joint venture partners. As such, Sall Myers Medical Associates in no way warrants either the accuracy or completeness of the information contained herein, and they are not responsible for any errors or omissions or for the results obtained from the use of such information. Readers are encouraged to confirm the information contained herein with other reliable sources.

© 2025 Sall • Myers Medical Associates. All Rights Reserved. Address: 611 River Drive, 4th floor, Elmwood Park, NJ 07407
 

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