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Office locations

Midtown West
425 West 59th St. 10th Floor
(bet. 9th and 10th Aves.)
New York, New York 10019
Fax: 212-523-6364

Upper Westside
1090 Amsterdam Ave.-Suite 9B
(corner 114th St.)
New York, New York 10025
Fax: 212-663-2612

Patient Information

The following patient forms are provided to simplify and expedite your visit to our office.

New Patient Registration Form
To facilitate your first visit, please print out and complete the following form. Along with the form, please bring your insurance card, any referrals, and your co-pay (our offices accept any form of payment). We also request that you arrive 15 minutes before your appointment.

Snoring / Sleep Apnea Questionnaire
If you have a snoring or sleep related appointment, please print out, complete, and bring in following form. It will assist the progress of your visit.

Authorization for Release of Information
The following form authorizes a release of your patient information.

All doctors of Head & Neck Surgical Group are affiliated with St. Luke's / Roosevelt Hospital. Many are also affiliated with Lenox Hill Hospital, Manhattan Eye Ear & Throat Hospital, Columbia University College of Physicians and Surgeons, and other premiere hospitals in New York City. Our physicians participate in a wide variety of medical insurance plans in order to provide care to a broad selection of patients.