For your convenience, please print and fill out all applicable forms and present them to the front desk when you arrive for your office visit.
- Adult New Patient Intake Form
- Formulario de Admisión de Pacientes Adultos Nuevos
- Pediatric New Patient Intake Form
- Formulario de Admisión de Pacientes Nuevos de Pediatría
- Preoperative Screening Tool
- Notice of Privacy Practices
Medical Records
To request your medical record, please complete the Authorization to Release Medical Information Form / Autorización para Divulgar el Formulario de Información Médicos and fax the completed form to (212) 305-0116.
Learn more about HIPAA patient privacy information.