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  • 4: Coverage Areas
  • 5: Our Physicians
  • 6: FAQ
  • 7: Contact us
  • 8: Links and Forms

Information & Education
Useful Website Links

  • American Academy of House Call Physicians
  • Alzheimer's Association
  • American Diabetic Association
  • American Heart Association
  • Arthritis Foundation
  • American Cancer Society
  • Web MD
  • American College of Physicians
  • American Academy of Family Physicians
  • American Medical Association

Patient Forms

During your initial evaluation over the telephone, the physician may instruct you to print out and complete some of the forms listed below, prior to our arrival.

  • Consent to Treat & Release of Records
  • HIPAA
  • New Patient Registration
  • Health History
  • Fees & Payment
  • Physician H&P
  • Physician Progress Note

If you believe that your symptoms require emergent treatment, you must dial 911 first, instead of waiting for a response from us. Emergent symptoms include but are not limited to: chest pain, severe shortness of breath, sudden loss of consciousness, vision loss, traumatic injury, sudden weakness/ numbness, as these symptoms may indicate more serious conditions that would be better suited for further evaluation in the closest emergency room.

NJ Medivisits | Dr. Veejay Geria | 292 Bloomfield Avenue Level 2 | Montclair  NJ 07042 | Phone: 877.865.7457 | eMail Us

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