NYOH New Patient Forms & Information

New Patient Forms

We’re honored to be part of your care team. To help make your first visit as smooth as possible, we’ve provided our new patient forms here for you to download and complete ahead of time, as well as new patient resources.

You should have also received these forms and documents in the mail. If you didn’t receive them or prefer to complete them digitally, you can access them below.

Here’s how to prepare:

  1. Download and print the forms.

  2. Fill them out at your convenience.

  3. Bring the completed forms with you to your first appointment.

If you have any questions while completing your paperwork, please contact us at the office where your appointment is scheduled. We’re happy to help.

HIXNY Electronic Data Access Consent Form NYOH

Assignment of Benefits & Financial Responsibilities

General Consent for Physician Services

New Patient History Form

Notice of Privacy Practices Acknowledgement

Patient No-show Policy

Authorization for the Release of Health Information

New Patient Resources and Documents

New Patient Information Brochure

Navigating Care (Patient Portal)

Notice of Privacy Practices Summary & Non-Discrimination

AMMA Coolerheads – Portable Scalp Cooling

Patient Bill of Rights

Notice of Privacy Practices