New Patient Form Packet

As a first time patient we have made it easy for you by offering health related forms online. Please select the appropriate form(s), fill them out online and submit them 24-48 hours prior to your appointment. Your forms will be delivered directly to our office when you press done. By using this service your personal health information is protected. You may schedule an appointment once the credit card authorization is completed by calling our office at 914-666-4665. Email: Info@DanielCameronMD.com Fax: 914-666-6271. You will not be charged until you office visit. If you cannot complete the form electronically, click the link here for PDF forms to download.

Downloadable Forms

If you’re not able to fill the forms out online, we’ve included them below. Click on the links below to download and print out these forms at home, where you can fill them out at your leisure and email them to Info@DanielCameronMD.com or fax them to 914-666-6271.

Hours and Location

Our office is located in Mt. Kisco, New York, 45 miles north of New York City at 344 East Main Street, Suite 104, Mt. Kisco, NY 10549 (for directions please click here.)

Our appointment hours are as follows:

• Monday-Friday: 8:30am – 5:00pm

What do I need to bring to my appointment?

• Information about any recent hospital stays Lab or diagnostic imaging reports (CT, x-ray, MRI, ultrasound). If you don’t have the report, let us know where the lab or imaging test was performed and we can request the report for you.
• Current medications: name of the medication, dosage and milligrams.
• Questions that you would like to ask Dr. Cameron. At times patients may have a list of questions they want to ask but forget them once they get to their appointment. We’re happy to answer all of your questions and a written list can help ensure we do.
• You may choose to bring a spouse, relative, or close friend with you to assist with the evaluation.
• it is helpful for you to call ahead of you appointment to ensure all necessary paperwork has been completed efficiently

What do I expect during my appointment

Your first visit with Dr. Daniel Cameron will begin with introductions to our staff, and will include a a comprehensive evaluation, which will include obtaining a thorough medical history, reviewing prior medical records and test results, and performing a physical exam. Additional laboratory and diagnostic tests and/or consultations with specialists may be needed.

Payment Policies & Insurance

Payment is expected at the time of your visit either by cash, check, or credit card. Office charges may or may not be covered by your insurance plan. We are considered “out of network” so it will depend on your individual insurance policy and the coverage of that policy as to the services and amounts they may reimburse. If you’d like to check with your insurance company prior to your appointment, visits are typically considered level 5 office visits.

Our office does not bill your insurance directly but we will gladly provide an invoice at the conclusion of your visit with your diagnosis codes, treatment codes and all pertinent provider information to you so that you may send it to your insurance company for reimbursement of billable services. We are also not a participating provider in Medicaid or Medicare.

Dr. Daniel Cameron’s Approach