Before your first visit
New patient forms
Fill out before your first visit and bring it, or arrive 15 minutes early to fill it out at the clinic.
New patient packet
- Patient registration & insurance
- Health history & medications
- Intake questionnaire
- Conditions of registration
- Privacy notice & acknowledgement
How to fill it out
- On your phone or computer: open the PDF, tap each box to type, then save it and print it.
- On paper: print it and fill it out by hand.
- Bring it to your first visit with a photo ID and your insurance card(s).
Please don’t email or text completed forms. They contain private health information. Bring them with you instead.
No appointment yet? Request an appointment or call Midwood (718) 252-0625 · Boro Park (718) 831-2333 · Staten Island (718) 816-6111.