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       Patients should bring the completed registration form, which can be downloaded from our webpage, or obtained from the office assistant. Do not try to email the form back since this (as much as any e-mail communication about medical issues) is forbidden by HIPPA regulations. Accurate description about current and past medical problems is crucial as this not only will significantly shorten the office visit but also will make the process of understanding your condition, figuring an adequate treatment plan and scheduling surgery much faster, effective and safe.


       If you are a part of an HMO then you need to have a referral from your primary care doctor. While patients with PPO plans may call our office directly and request to be seen, in general an office visit is warranted based on prior evaluation of relevant MRI findings of the brain or spine. If a patient cannot have an MRI (for example because she/he has a pace-maker) then CT is acceptable.  Any imaging study has to be less than six months old and our office can help with the process for required imaging.

Dr. Marsella personally reviews all image studies and doesn’t formulate an opinion based solely on a radiology report. While Dr. Marsella has access to many radiology facilities, it is best to inquire before your appointment if you need to bring a CD.






       At the time of the initial visit, usually we go through your previous medical and surgical history as well as your current list of complaints. Pertinent neurological exam will be completed and imaging studies will be discussed with the patient. Finally, discussion about conservative versus surgical treatment will take place and specific treatment options will be tailored to each case. It is also possible that before discussing management options, referral(s) to other specialist(s) may be necessary and final decisions will be postponed until a different consultation is completed. The doctor will also explain risks and benefits of every surgery.  Work related forms for absence of leave or similar will not be filled until the day of hospital admission.






       Following your discharge from the hospital a follow up visit is scheduled within 7-10 days. If any complication occurs during this time you will be able to reach the doctor 24/7 either through the office (during regular hours) or directly via pager (after hours or weekends). Pain medication will be re-filled at the time of the first appointment; in any case narcotics may not be called in to your pharmacy so you are responsible to request refills with appropriate timing.  

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