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If you would like to schedule an appointment please call the office at 212-759-4969 or click here to e-mail us.
In order to expedite your registration as a new patient, you may complete the following four forms from the convenience of your home.
Please Note: You will need Adobe Acrobat Reader to download the files.
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Please click on:
- Financial Information Form
- Patient Information, Medical Assessment, Insurance information, & Consent for Treatment Form
- Health Information Portability and Accountability Act (HIPAA) forms:
| The HIPAA Notice of Private Practices form is strictly informational and intended for you to keep. Once you have read this form fill out the HIPAA Acknowledgement form and return it to the office with Patient Information, Medical Assessment, Insurance information, & Consent for Treatment Form and Financial information form. |
Then print and fill out all the appropriate forms and either:
- Mail- 133 East 58th Street, Suite 803
New York, NY 10022
- Fax- 646-735-1843
- Or bring the forms with you to your appointment
For additional information on the concerning the HIPAA regulations click here to visit the U.S Department of Health and Human Services Website. |
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Schweitzer & Poole, PC
133 East 58th Street, Suite 803
New York, NY 10022
Tel: 212-759-4969
Fax: 646-735-1843
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