Online Patient Forms
Please print and complete the appropriate forms before your visit.
We try to keep information on all our patients as current as possible. If any of important information has changed since your last visit (i.e. insurance carrier, address, etc.) please complete a new Patient Information form as well.
Click each link below to download an Acrobat Reader® file for each form. If you don’t have Acrobat Reader® on your computer, click here for a free download.
Patients can fill out forms online, PRINT the forms and either
- Bring them to your appointment
- Fax them to Dr. Hammerschlag’s office at 212-472-1336
- Postal mail them to Dr. Hammerschlag’s office
Dr. Paul E. Hammerschlag, MD, FACS
863 Park Avenue New York, NY 10075 Suite 1E
- Be sure to SIGN forms where required before mailing or faxing
to Dr. Hammerschlag
The following forms are available online and open in a new window or tab:
Notice of Privacy Practices (You do not have to download this form, but you should read it online).