Patient Intake Forms

Prior to your first visit, please fill out the new patient intake form and print it.

Also bring proof of ID along with your insurance information when you come for treatment.

This will speed up the time it takes to get you started at ProMet!

Patient Intake Forms

These forms are used to collect general demographic information as well as a basic medical history. Please do not complete or sign the Consent of Treatment form until one of our Patient Care Coordinators goes over your health plan benefits and financial responsibility with you at your first visit.

No Fault - Workers Comp Questionnaire

This questionnaire is used to collect information regarding your case. If you have a Workers Compensation case, it is especially important that you provide your employer’s name and address.

Patient Intake Forms - Spanish

Estas formas son para agregar informacion basica demografica y un historial medico. Por favor no llene la forma de Consentimiento hasta que alguien en nuestra oficina le explique sus beneficios medicos y costo cuando venga a su primera visita

Testimonial Consent and Release Form

This form is used to get your permission to publish your statements/photos/videos on any ProMet-owned platform including our website and social media accounts.

Patient Data Packet

These forms are used to collect general demographic information as well as a basic medical history. Please do not complete or sign the Consent of Treatment form until one of our Patient Care Coordinators goes over your health plan benefits and financial responsibility with you at your first visit.

WC & NF Questionaire SPANISH

Este cuestionario se utiliza para recoger información sobre su caso. Si tiene un caso de compensación laboral, es especialmente importante que proporcione el nombre y la dirección de su empleador.

Data Packet Spanish

Estas formas son para agregar informacion basica demografica y un historial medico. Por favor no llene la forma de Consentimiento hasta que alguien en nuestra oficina le explique sus beneficios medicos y costo cuando venga a su primera visita

WC NF Questionaire

These forms are used to collect general demographic information as well as a basic medical history. Please do not complete or sign the Consent of Treatment form until one of our Patient Care Coordinators goes over your health plan benefits and financial responsibility with you at your first visit.

Find Your Location

Glendale, NY
Address:

71-19 80th Street, Suite 8210
Glendale, NY 11385

Phone:

(718) 554-6610

Email:

AtlasPark@ProMetPT.com

Hours:

Monday - Friday: 8am - 8pm
Saturday: 9am - 1pm
Sunday: Closed

Briarwood, NY
Address:

138-28 Queens Boulevard, Store C
Briarwood, New York 11435

Phone:

(718) 880-2385

Email:

Briarwood@ProMetPT.com

Hours:

Monday - Friday: 8am - 8pm
Saturday: 9am - 1pm
Sunday: Closed

Manhasset, NY
Address:

444 Community Drive, Suite 103
Manhasset, NY 11030

Phone:

(516) 365-3344

Email:

Manhasset@ProMetPT.com

Hours:

Monday - Friday: 8am - 8pm
Saturday: 9am - 1pm
Sunday: Closed

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