Patient Resources & Forms
We look forward to meeting you on your first visit to our office. During this time, we will help you get acquainted with our office and learn about your urology treatment. We understand that each patient’s treatment is different, and we promise to give you the personal attention you deserve. We also know that your time is a precious commodity, so we have our Patient Information and Office Policies forms here for you to download and complete for your first visit with our office.
Patient Visit Forms:
Patient Registration (Spanish)
HIPPA Privacy (Spanish)
HIPPA Privacy Practices Release
HIPPA Privacy Practices Release (Spanish)
Male Patient History (Spanish)
Female Patient History (Spanish)
Patient Follow Up Form (Spanish)
LOCATION
- 535 Plandome RoadManhasset, New York 11030
516.627.6188 | Phone
516-627-9397 | Fax
OFFICE HOURS
Monday (for bookings only) | 9:00am – 5:00pm |
Tuesday | 8:00am – 11:00am |
Wednesday | 7:30am – 11:00am |
Thursday | 8:00am – 6:00pm |
Friday | 7:30am – 4:00pm |
Saturday | Closed |
Sunday | Closed |
Bookings for the MonaLisa Touch cannot be
taken online. Please call 516-627-6188 ext. 7015
to schedule an appointment.