Online Patient Forms

Director at CHC

Dr. Hammerschlag is on the board of directors and an active provider to the nonprofit, Center for Hearing and Communication, which has been been providing hearing care since 1904.

New York Super Doctor

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:

Assignment and Release

Dizziness/Vertigo Questionnaire

New Patient Form

Patient Responsibility Notice

Privacy Acknowledgement Form

Notice of Privacy Practices (You do not have to download this form, but you should read it online).

Practice Announcement

Dr. Paul Hammerschlag has retired after a long and distinguished career. His friend and colleague, Dr. Darius Kohan, Associate Professor at NYU School of Medicine and Director of Otology/Neurotology at Lenox Hill Hospital and MEETH, will continue to manage his practice and provide continued care for his patients. Please contact his office at 1-212-472-1300 to schedule an appointment.


Please read Dr. Hammerschlags' full retirement and practice transfer announcement here.

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