New Patient Forms
We would like to welcome you to Mount Sinai Doctors-Long Island Heart.
In order to expedite the registration process for your first appointment, please arrive 15 minutes early. Patient registration forms are attached here for your convenience. You can download them and fill them out ahead of time if you choose.
- Patient Information Form
- Financial Authorization Form
- Notice of Privacy Practices – please review this document and sign the receipt of notice below
- Receipt of Notice of Privacy Practices
- Agreement to Receive Messages with Protected Health Information
If you have any questions regarding these forms, please call your physician’s office. We also ask that you provide photo identification and your insurance card at the time of your visit.
We look forward to meeting you and thank you for choosing Mount Sinai Doctors-Long Island Heart.
Practice Information
Mineola
200 Old Country Road
Suite #278
Mineola, NY 11501-4298
Phone: 516-877-0977
Fax: 516-294-6861
Hours: Monday – Friday, 8 am – 5 pm
Saturday and Sunday by appointment
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Five Towns
1436 Broadway
Hewlett, NY 11557
Phone: 516-537-5363
Fax: 516-342-5686
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Forest Hills
99-01 Queens Boulevard
Rego Park, NY 11374
Phone: 718-268-6300
Fax: 516-294-6861
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