Download New Patient Forms

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 prior to your appointment. Click the links below to begin downloading the new patient forms.

New Patient Registration Form

Payment Policy Form

Health History Form

Consent for Treatment Form

How Do I Submit the New Patient Forms?

  1. Bring the physical forms with you the day of your first visit OR
  2. Send them to: The Salerno Center 345 E 37th St, Suite 208
    New York, NY, 10016 OR
  3. Fax them to: 212.582.1727 (Please put "Attn: New Patient Coordinator" on your fax cover sheet.)

What Do I Need to Bring to My First Visit?

  • It is imperative that you send, or bring with you, any lab work you've completed 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.