New Patient Forms

Medical History and HIPAA Forms

Please download and complete the following three forms and bring them with you to your first visit with us.  Thank you!

 

This “HIPAA Notice of Privacy Practices” is for your own personal review.

HIPAA Notice of Privacy Practices
HIPAA Notice

 

Please call ☎ Merrick Office Phone Number 516-378-8600 with any questions or to schedule your appointment.