Download New Patient Forms
Once again, welcome and thank you for choosing The Salerno Center.
The following documents are an integral part in our collaborative journey to better health and wellness.
Please take the time to carefully complete each form. Many tests you will have at your first visit are based on the evaluation of the health history questionnaire.
Please Note: It is important that we receive all forms 5 days prior to your appointment unless otherwise discussed with our New Patient Coordinator.
Mail Forms to:
The Salerno Center
Attn: New Patient Coordinator
161 Madison Ave, Suite 7SW
New York, NY 10016
*Fax Forms to: 212.582.1727,
please put "Attn: New Patient Coordinator" on your fax cover sheet
Please Note:
- It is also imperative that you send, or bring with you, any lab work you've had within 6 weeks of your appointment or Dr. Salerno will have to repeat the tests.
- Also, send or bring written reports of the most recent tests (X-rays, EKG...) that you have had within a year prior to your appointment to aide in your health evaluation.
Please feel free to contact us with any questions you may have. We are truly here to help you.
Click on Form Name to Download:
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