What to Bring

It is important to have all the required documents with you when visiting our health care facility. We’ve compiled a handy patient checklist to ensure you have a smooth experience once you arrive at the Nurse Practitioner Group. Please bring the following with you when visiting:

  • Patient forms
  • Updated personal information
  • Insurance card (see list of accepted insurance plans)
  • Government-issued ID
  • Pharmacy information
  • Updated medical and family history
  • List of allergies
  • Outside medical records
  • Immunization history
  • Medication list

Patient Forms

If you are a new patient, please fill out the following patient forms before your first visit:

English

 

Need to Request Your Health Information?

 

Spanish

 

¿Necesita Solicitar su Información de Salud?

 

Please bring the completed patient forms with you, along with your ID and insurance card, on the day of your visit.

 

If you would like to fill out these forms at our office, please plan to arrive 20 minutes early.

House Calls

If you are a provider or agency referring a patient for House Calls, please fill out the following form:

Please send the completed form to Melissa at fax # 212-342-0093.

“When I was going through menopause, I was anxious about it. Here, my practitioner told me everything I could have wanted to know, from soup to nuts. That’s why I love her.”
– Patient