NEW PATIENTS

New Patient Application

To become a new patient, you may apply online or call.

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About the Application Process

We are presently scheduling new patient appointments Six to Seven Weeks Out.  The practice maintains a wait-list which is updated daily.​  Only the potential new patient may complete this application unless under the age of 18.  In accordance with patient privacy and New York State Mental Health Hygiene regulations we are unable to accept applications if they are not submitted by the potential new patient.  All applicants must be considered "Willing Patients."​  All applications are processed on Tuesdays at 12:00pm.  Determination for eligibility of health insurance benefits and services will be made at that time.

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About the Wait

Unfortunately, Long Island is experiencing a Shortage of Mental Health Providers.  As a result, we ask that all applicants be patient as we process your application.  We have been currently receiving high volumes of applications to process and consequently have been booking further out than we would like.  We appreciate your patience as we work together to accommodate as many applicants as possible while providing the best treatment outcomes as possible.

Alternative Arrangements

Sometimes we find that we are unable to accommodate applicants for a variety of reasons, such as an applicant's health insurance company will not cover treatment at our practice, an applicant may be experiencing financial hardship, we may not offer the variety of services an applicant may be looking for, or the applicant's personal and work schedule doesn't have the same availability that our current clinician's schedules have for treatment.  In that event we will discuss with our applicants alternative arrangement options outside of our practice; including referrals to other treatment programs, clinics, or private practices.  

Emergencies

At this time, the practice does not maintain an "Urgent Care" status and we are unable to accommodate "same day" new patient appointments.  If you are experiencing a true psychiatric or health emergency please go to your nearest emergency room or dial 911.

General Information

Upload Image of Primary Health Insurance ID Card (Front Side of Card)
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Upload Image of Primary Health Insurance ID Card (Back Side of Card)
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Upload Image of Secondary Health Insurance ID Card (Front Side of Card)
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Upload Image of Secondary Health Insurance ID Card (Back Side of Card)
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Treatment Information

What brings you to our practice? (Check All That Apply)
What services are you currently seeking at our practice? (Check All That Apply)

Treatment Availability Information

Are you a full-time or part-time resident of the East End?

Additional Information

Submission

Terms and Conditions:

Please be advised that this protected health information will be used to confirm directly with third party health insurers your health insurance benefits and eligibility for services that may be rendered by our practice.  Additionally please be advised that this protected health information from this web page will be transmitted to our office by email.  Please understand that in accordance with the with New York State Privacy and confidentiality laws and regulations (1) we cannot guarantee the security of email transmissions, (2) it may be inadvisable to send us sensitive or private information by email, to which you may choose to use an alternative and more secure means such as a telephone call and or facsimile, (3) no evaluation or treatment is or will be offered by email communication,  (4) we accept but cannot assure you whether or when we will respond to email communications, and (5) if we do respond, there may be a delay, so do not use email for any urgent matters or to communicate with us if a healthcare emergency arises; we do not check emails frequently enough.   By submitting this page you accept and agree that we may reply to this message by email. 

Contact

332 West Montauk Hwy Suite 5
Hampton Bays,  NY  11946-3551

631-495-3300 Office

631-822-2833 Fax

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M  2-6pm

Tu 11-8pm

W  9-6pm

Th 9-6pm

F   9-6pm

Office Hours

THE CONTENT OF THE SITE IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY AND IS NOT, AND SHOULD NOT BE CONSIDERED TO BE, MEDICAL ADVICE. THIS INFORMATION IS NOT INTENDED TO CREATE, AND RECEIPT OF IT DOES NOT CONSTITUTE, A PHYSICIAN-PATIENT RELATIONSHIP. THE CONTENT IS NOT INTENDED FOR USE IN THE DIAGNOSIS OR TREATMENT OF ANY INDIVIDUAL CONDITION OR AS A SUBSTITUTE FOR A CONSULTATION WITH A LICENSED MEDICAL PROFESSIONAL. THE CONTENT SHOULD NOT BE CONSIDERED COMPLETE; IS NOT EXHAUSTIVE; AND DOES NOT COVER ALL DISEASES, AILMENTS, PHYSICAL CONDITIONS, OR THEIR DIAGNOSIS OR TREATMENT. THE CONTENT SHOULD NOT BE USED IN PLACE OF A VISIT, CALL OR CONSULTATION WITH, AND THE ADVICE OF, YOUR PHYSICIAN OR OTHER HEALTH CARE PROVIDERS. SHOULD YOU HAVE ANY HEALTH CARE-RELATED QUESTIONS, CALL OR SEE YOUR PHYSICIAN OR OTHER HEALTH CARE PROVIDER PROMPTLY. TALK TO YOUR DOCTOR OR PHARMACIST BEFORE TAKING ANY PRESCRIPTION OR OVER THE COUNTER DRUGS, INCLUDING ANY HERBAL MEDICINES OR SUPPLEMENTS. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE, OR DELAY IN SEEKING IT, BECAUSE OF SOMETHING THAT YOU HAVE READ ON THE SITE.

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