Below you will find links to forms that you may download, print and complete prior to your initial visit. Please be sure to read and complete all documents in full. To expedite your waiting time in the office, you may fax your completed forms to us along with a copy of your photo ID and insurance card (front & back) to (516) 374-5816. However, if you prefer, you may bring the completed forms in with you to your appointment.
Patient forms are in .pdf format. Adobe Acrobat reader is required to open each file. To download your free copy of Adobe Acrobat click here.
If your appointment is the result of a job-related Workers’ Compensation case, please print and complete the Workers’ Compensation Information Forms. Please print these forms and fax the completed forms to us at (516) 374-5816 or bring them with you to your appointment.
If your appointment is the result of an automobile accident, please print and complete the No Fault Information Forms in addition to the New Patient Information Forms. Please print these forms and fax the completed forms to us at (516) 374-5816 or bring them with you to your appointment.
Important New Patient Information
Please bring the following when you come for your first visit:
All forms you have completed at home. If you are unable to complete the forms, please arrive 15 minutes prior to your scheduled appointment so that we may assist you.
You must bring your health insurance card(s) with you and photo ID.
If your visit is due to an accident, such as Workers’ Compensation or No Fault claim, it is important that we have all insurance information at the time of your visit. If you can not provide this information, you will be responsible for payment at the time of your visit.
All fees and co-payments are due at the time of service. Please refer to your insurance plan on what charges are covered. Any charges that are not covered are the patient’s responsibility and are payable at the time of service. Payments are acceptable in cash or by check or credit card (VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVER).