Patient Intake Forms
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 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:
Email:
Hours:
Monday - Friday: 8am - 8pm
Saturday: 9am - 1pm
Sunday: Closed
Briarwood, NY
Address:
138-28 Queens Boulevard, Store C
Briarwood, New York 11435
Phone:
Email:
Hours:
Monday - Friday: 8am - 8pm
Saturday: 9am - 1pm
Sunday: Closed