For New Patients

welcomeOur goal is to provide the best possible care for your children.  We understand that choosing a pediatrician is a big decision, so we want the process to be as smooth as possible for your family.  To become an established patient at the practice, we advise our patients to make sure that we accept their insurance plans first and highly suggest reading our insurance policy as well.  New patients should contact their insurance provider to select one of our physicians as their designated provider (PCP), if not done so this might result in charges being denied by your insurance and you will be personally responsible for all visits/service.

babyTo schedule your first appointment, we will ask you to provide us with your contact and insurance information over the phone. For patients transferring care from another physician’s office, we require documentation proof of immunizations before we can schedule the first appointment as well. To expedite the process, new patients are welcome to download the forms online before their visits.  We also ask you to bring a valid ID (driver’s license or passport) as well as a credit card to put on file for future use.

Medical Forms

For your convenience, you can find below any necessary medical forms that new patients will need to complete.  If you have any questions regarding the forms, please feel free to contact our office.

Registration New Patient

Demographic Update

Privacy Notice

Office Policy 2020

Financial Policy 2020

Photo Consent

Authorization To Disclose Health Information Via E-Mail

Adolescent HIPAA Consent 2020

Credit Card Request Form

NYUMC UPN HIE Connection Consent Form

Refund Request Form

In response to the COVID-19 outbreak, we are now offering Telemedicine/Video Visits and Rapid COVID PCR Testing in office. Meet with your doctor to get a prescribed treatment plan, refill or get a new prescription and much more all from the safety and comfort of your home.