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Patient Information

Hospital Affiliations | Patient Forms | What to Bring to Your Appointment
Appointments and Cancellations | Insurance and Payment Information

Hospital Affiliations

Dr Rasul is affiliated with the following medical facilities:

• Northern Nevada Medical Center, Sparks, NV
• West Hills Hospital, Reno, NV
• Saint Mary's Regional Medical Center, Reno, NV
• Renown Regional Medical Center, Reno, NV

Patient Forms

Thank you for choosing Mujahid Rasul, M.D. For your convenience, we have provided the following patient forms for you to print and complete before your office visit. All forms must be completed and returned at least (3) business days prior to your first appointment.
[PDF Help]

• Patient Information Form
  Patient information and billing form

• Financial and Office Policy
  Financial and office policy form

• Consent of Treatment
  Consent for medical treatment
  Medication consent
  Developmental questionnaire

• Notice of Privacy Practices
  Acknowledgement receipt of privacy practices
  Patient record of disclosures

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can get access to this information. It is given to all new patients and a copy is available upon request.

What to Bring to Your Appointment

New patients are required to check-in 20 minutes prior to your scheduled time. Please bring the following with you to your first appointment:

• Insurance Card(s) – if applicable
• Photo ID
• Co-pay/Co-insurance/Deductible/Balance is due in full at the time of service.

Appointments and Cancellations

If you cannot keep your appointment, please call 775.322.4666 to cancel or reschedule your appointment at least 24 hours in advance on a business day. When an appointment is missed, another patient that needed to be seen may have been unable to do so because that time slot was already taken. We do understand that emergencies occur and will work with you on an individual basis should such occur.

Insurance and Payment Information

We accept Medicare and most major insurance plans, please contact our office to find out if we accept yours. We accept Visa, MasterCard, Checks or Cash (please bring exact change as our office does not carry any change).

For questions regarding our patient information forms or policies,
please contact our office at 775.322.4666.

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