Adult Registration

New patients, please print and complete the appropriate form below, and either bring or fax it. Bring your insurance card, and if applicable, your co-payment in cash or check, to your first appointment. Take the time review our fee and cancellation policy below as well. Thank you!

 Our fax number is 516-785-6026.

Adult Registration

Insurances Accepted:

Aetna

Blue Cross/Blue Shield

Emblem Health/HIP/GHI

The Empire Plan NYSHIP

United Health Care (including Community Plan)

Medicare

Cigna

Magnacare

Affinity

Oxford

Questions? Appointment Request? Concerns?

If you would like us to give you a call, please complete this brief form and we will contact you within one business day.

Our Office Locations

Open 7 Days 8am - 10pm

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