Resources

Below are links to forms that you will need to download, print and complete prior to your initial visit. Please be sure to read and complete all documents in full.

Forms are in .pdf format. Adobe Acrobat reader is required to open each file. To download your free copy of Adobe Acrobat click here. To save files to your computer right-click the links below and select “save target as”.

 

New Patient Forms

Registration form
Patient record of disclosures
Office policy
Patient consent for use and disclosure of protected health information

 

Important New Patient Information

You must bring your health insurance cards with you.
All fees and co-payments are due at the time of service. Please refer to your insurance plan for information on what charges are covered. Any charges that are not covered are the patient’s responsibility and are payable at the time of service. We accept cash, check, or credit card. We accept the following credit cards:

• Visa

• MasterCard

• Discover

• American Express

If you are unable to keep your appointment, please notify us as soon as possible at 631-676-7656.

If you have any questions, please do not hesitate to contact the office.

Medical Records Release Form