Patient Form

To streamline your visit, please review and complete the necessary forms prior to your appointment. If you have any questions, feel free to contact our office.

New Patient Registration Form

Please complete this form if you are a new patient and bring it to your appointment—unless already submitted via the patient portal.

Financial Policy

Please read and sign this form if you are a new patient. Bring it with you to your appointment.

Personal Health Information Release Form

Complete this authorization if you would like your medical records sent to another provider.

Hearing Difficulty Questionnaire

A simple questionnaire to help determine if you may be experiencing hearing loss.

Contact Us Today

Call us at (845) 294-0661 or schedule your consultation