Forms
Patient Registration Form
Download the fillable PDF form and complete it in its entirety before your visit. You will need the free Adobe Acrobat Reader, or Preview on a Mac, to view and type into the form.
Prepare for Your Visit
Patient Forms & Information
Patient forms and information for Marc Haspel, DPM in Clifton, NJ: to save time, fill out your patient registration form before your scheduled visit and review what to bring to your appointment.
Thursday & Saturday Hours
Open until 6 pm Thursdays and 9 am–12 pm on alternate Saturdays
Before Your Appointment
Forms & Patient Resources
Download the fillable registration form, review our policies and access online services before your visit. For coverage and payment details, see our Insurance & Billing page.
Privacy
Notice of Privacy Practices
Learn how your health information may be used and disclosed, and how you can get access to this information.
Your Visit
What to Bring to Your Appointment
- Health insurance card(s)
- Photo ID
- Primary care doctor’s name and phone number
- Referral from your primary care doctor, if your insurance requires one
- List of current prescription and over-the-counter medications, including dose and frequency
- Your medical and surgical history
- Any previous X-rays, MRIs or test results related to past foot conditions
Policies
Cancellation Policy
If you are unable to keep an appointment, please give us at least 24 hours’ notice so we can offer the appointment to another patient. A fee may be charged if a patient does not show up for an appointment without sufficient notice.
Billing
Pay Your Bill Online
Pay your bill securely online through our billing partner.
Online Access
Patient Portal
Log in to the patient portal to access your account online.
Need Help With Patient Forms?
If you’re unsure which document you need or have questions before your appointment, contact our office and our team will be happy to help.
Book Your Visit
Ready to Schedule Your Visit?
Book online or call our Clifton, NJ office and our staff will help you find a time that works. Call (973) 777-4650 or book online.
- 1100 Clifton Avenue, Suite C, Clifton, NJ 07013
- Mon–Fri from 9 am · Thu until 6 pm · Alt. Sat 9 am–12 pm
