Child & Adolescent 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.


Child and Adolescent Registration

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

No Hours settings found. Please configure it