Patient Forms

If you are a new patient or have not been to the office within the past 12 months, please print and complete our Patient Registration Forms below prior to your visit. You may either fax them to 212-675-0540 or bring the day of your appointment. Remember to bring your current insurance card, photo ID and valid referral if required by your insurance. Please arrive 10 minutes early if you would rather complete forms in the office.

Download Patient Registration Forms

The office generally runs on time.

We look forward to seeing you. This appointment is reserved for you, and while most patients are able to keep their appointments, we ask that if you must cancel or reschedule, you do so no less than 24 hours prior to your scheduled visit. In order to maintain a smooth patient flow and accommodate all patients, there is a $50 cancellation fee for medical visits and a $200 cancellation fee for cosmetic treatment visits automatically billed to patients who cancel/reschedule less than 24 hours in advance or fail to keep their appointment.

Patients without required referrals will be asked to reschedule.

Medical Records Release Form

Parental Consent for Treatment of a Minor

General Treatment Consent

You may also familiarize yourself with the

HIPAA Notice of Privacy Practices

Please see the Appointments page for more details.