Patient Forms, Instructions and Telehealth Visit

• New Patient Registration & Health History
• Medicare Advanced Beneficiary Notice of Noncoverage
• Current Medication List

Additional Forms for Thyroid Patients

• Thyroid Eye Disease Questionnaire
• Sleep Apnea Screening Form

Adult Surgical Forms

• Adult Surgical Questionnaire
• Adult Medical Clearance Forms
• Adult Surgical Pretesting Criteria
• Icing Instructions

Pediatric Surgical Forms

• Pediatric Surgical Questionnaire
  

Administrative Forms

• HIPAA and Privacy Statement
• Medical Records Release Form

Video/ Audio Consult Waiting Room

Please call to schedule your Telehealth Video Visit (212) 305-5477