New Patient Info and Forms

As a patient in the practice of Schweitzer and Schweitzer, PC, you should expect only the absolute highest standard of care. All of our doctors are Prosthodontists; specialists in aesthetic, restorative, and implant dental care. We also serve to satisfy all of your primary dental health care needs, including periodic cleanings and check-ups. In order to keep as current as possible, our doctors are active in teaching at local universities and hospitals, members of regional and national specialty organizations and have published numerous articles in scientific literature.

Schedule Appointment

If you would like to schedule an appointment, please visit the link below.

SCHEDULE AN APPOINTMENT

You may also call our office directly at 212-759-4969 or email us through our Contact Form to schedule. We look forward to meeting you and satisfying your dental health care needs!

Patient Forms

In order to expedite your registration as a new patient, you may complete the following four forms from the convenience of your home.

NEW PATIENT FORMS

Please Note: You will need Adobe Acrobat Reader to download the pdf forms. Mac users: Please use Acrobat Reader instead of Preview to edit the forms. (Right click and select “Save link as…”)

1. Financial Information Form
2. Patient Information, Medical Assessment, Insurance information, and Consent for Treatment Form
3. Health Information Portability and Accountability Act (HIPAA) forms:
   • Acknowledgement Form
   • Notice of Privacy Practices Form

After downloading our new patient forms, please either:

1. Electronically fill the forms out and attach to an Email addressed to [email protected]
2. Fill the forms conventionally and either:
   • Mail – 133 East 58th Street, Suite 803 New York, NY 10022
   • Fax – 646-735-1843
   • Or bring the forms with you to your appointment

The HIPAA Notice of Private Practices form is strictly informational and intended for you to keep. Once you have read this form fill out the HIPAA Acknowledgement form and return it to the office with Patient Information, Medical Assessment, Insurance information, & Consent for Treatment Form and Financial information form.

For additional information on the concerning the HIPAA regulations click here to visit the U.S Department of Health and Human Services Website.