For clinical evaluations, please first call 617.296.5437 or contact via email to schedule an appointment. Once scheduled, please download New Patient Registration Form, Authorization for Release of Protected or Privileged Information, Consent to Treatment and Office Policy Statement from the list below. You may e-mail or fax the completed forms to 617.607.9249 Attention: Dr. Ceranoglu, prior to your appointment in order to use our time more efficiently when we meet. Please keep in mind that e-mail may not be safe or not policed.
My office is located on Adams Street at Lower Mills area in Milton, and is on the second floor of the building. There is parking on the street almost everyday, except Thursday afternoons during summer months owing to Farmers's Market nearby. The closest T stop is the Red Line, which is across the street.
Please note that I do not participate in any health insurance plan. However, some plans will reimburse a portion of fees paid to “out-of-network” providers. You will receive a detailed statement of services listing the diagnostic and procedure codes required for this reimbursement process at the end of our appointments or each month if preferred.
New Patient Registration Form (Word document)
Consent to Treatment (PDF file)
Office Policy Statement (PDF file)
For your convenience:
HCFA-1500 form (PDF file) - For your use during reimbursement process with your health insurance carrier
75 Adams Street, Suite G
Milton, MA 02186
P (617) 296-5437
F (617) 607-9249