We thank you for choosing to see us. We hope you choose to fill out this survey and provide us your information online. Having your data in this format helps us help you. Consider asking a family member or friend for help if online forms are difficult for you.

If for any reason you wish not to fill out the form, just let our front desk know when you come in to see us. We will provide you a form to fill out at that time. We want to see you and improve your sleep regardless.

Financial Policy of Brian Abaluck, LLC.

Copays are due at time of service. If you do not have insurance, please inform us, and we will offer a fair price for our services. We work hard to respect your time and stay as close to schedule as possible. If you are 15 minutes late for an appointment, then seeing you could cause all subsequent patients in a session to be seen late, so we may reschedule your visit. If you schedule an appointment and then no-show, we may bill you $50.

Privacy Policy of Brian Abaluck, LLC.

We aim to keep your medical records safe. We will never sell your information. However, we do share information, for example, with your primary doctor, other doctors you wish to see our notes, care coordination networks in which we participate, and our billing agency. We detail how we use your information in our Privacy Policy. You may obtain our detailed Privacy Policy by requesting a copy from us at 2 Industrial Blvd, Suite 100, Paoli PA 19301 or at 484-888-0091. Dr. Abaluck, our privacy officer, can be reached at this address and phone number as well with any privacy concerns.

Scope of Practice Policy of Brian Abaluck, LLC

This practice treats only sleep disorders. Sleep disorders may contribute to neurological disorders, and we may discuss these links if you have a known neurological disorder. That said, among new patients, we do not evaluate or treat neurological disorders including but not limited to headache, memory loss, unsteadiness, seizures, numbness, weakness, vertigo, neuropathy, or pain. If we find evidence of a neurological disorder on history or exam, we can provide a referral.

By signing below, I authorize Brian Abaluck, LLC to use health information about me (or the patient for whom I sign) for treatment, payment, and health care operations purposes as detailed in our Privacy Policy. I understand and accept the scope of Dr. Abaluck’s practice. I also confirm that I have read, understand, and agree to the financial policy of Brian Abaluck, LLC.
Agreement with our Financial and Privacy Policies.
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