You can SUBMIT the information ONLINE form here

OR

You can print and fill out these forms BELOW (and BRING/FAX/EMAIL) so we can expedite your first visit:

PATIENT REGISTRATION FORMS:
Patient Information (page 1)

Patient Information (page 2)

In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download Adobe Reader.

Your first visit to Long Island Center for Ear Nose and Throat Health will involve special steps so that we can get to know you. Our web site will help you understand what to expect on your first visit to our office. You will find all the information you need, such as a map and directions to our offices, office hours, payment policies and more. We also describe our first visit procedures. You can save some time by printing out and completing the new patient forms in advance of your appointment.

What to expect

Being prepared for your appointment will

  • Ensure that the doctor has all of the needed information to provide the best possible care for you.
  • Help relieve any unnecessary anxiety you may be feeling.
  • Educate you on your symptoms by reviewing the content on this Web site.

We look forward to your first visit.

Patient-FormsSUPPORTING DOCUMENTATION REQUIRED:

  • Health Insurance Card
  • Referral, if required
  • Photo ID
  • Completed Patient Information Forms (above)

If you are scheduled for allergy test, please do not take any antihistamines 72 hours prior to your visit.

These include:

  • Allegra
  • Astelin nasal spray
  • Benadryl
  • Clarinex
  • Claritin
  • Meclizine
  • Tylenol pm
  • Xyzal
  • Zyrtec

Thank you for choosing the Long Island Center for Ear Nose and Throat Health Group to care for your ENT & Allergy needs. We look forward to providing you with the high quality care that you deserve.