Patient Forms

For your convenience you may print out and then fill out the forms listed below and either mail, email, fax or bring them to our office on the day of your first visit. Contact info can be found here. Or you may fill the forms out at our office when you arrive for your first appointment. If you wish to fill them out at the office please arrive 15 minutes early so that your evaluation and treatment can begin on schedule.

Patient Information Forms

Choose form(s) for applicable body part(s):

Additional forms needed for those with *NYS Empire Plan

Health Insurance

We participate in and accept most major health insurance company plans. If you do not see yours listed please call us to verify your coverage.

  • Aetna

  • Empire BCBS

  • Martin’s Point

  • MVP

  • POMCO

  • Wellcare

  • Blue Shield / Highmark

  • Fidelis

  • Medicaid

  • No Fault

  • Tricare (with the exception of active-duty members)

  • Workers Compensation

  • CDPHP

  • GHI / Emblem Health

  • Medicare

  • NYS Empire Plan

  • United Healthcare

  • CIGNA

  • Humana

  • Multiplan

  • Oxford

  • Univera