Patient Forms

Our registration forms and payment options are available below:

• Adult Registration Form (PDF, 1 page)

• Child Registration Form (PDF, 1 page)

• Payment Options (PDF, 1 page)

• Apply for our Interest-Free billing service

  • See Payment Options at left.

  • For charges less than $500, the Practice offers 6 months
    same as cash when you are accepted by Care Credit and                                                                                           pay-in-full within 6 months.

  • For charges more than $500, the Practice offers 12 months
    same as cash when you are accepted by Care Credit,
    and pay-in-full within 12 months.

  • To apply for Care Credit click here.

  • (Financing available to residents in the state of New York)

Adobe Acrobat Reader is a free program for PC and Mac computers that will allow you to view and print Portable Document Format (PDF) files on our website.