Click Here To Schedule A Consultation

Schedule a Consultation

  • This field is for validation purposes and should be left unchanged.

Covid-19 Screening Info

Please complete and return this form 48 hours prior to your scheduled appointment.

Covid-19 Screening

Name(Required)
Have you experienced any of the following symptoms in the past 48 hours:(Required)
Within the past 14 days, have you been in close physical contact (6 feet or closer for a cumulative total of 15 minutes) with anyone who is known to have laboratory-confirmed COVID-19?(Required)
Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?(Required)
Are you currently waiting on the results of a COVID-19 test?(Required)
In the past 14 days, have you traveled internationally or returned from a state identified by New York State as having widespread community transmission of Covid 19 (other than just passing through the restricted state for less than 24 hours).(Required)

Call Us (212) 535-3088