New Patient Forms


 

We are pleased to welcome you to Dr. Alla Khalfin's practice. In order to expedite your appointment, please fill out and submit the forms below prior to your appointment.

New Patient Forms:

Copay and No Show Consent

Insurance Information

Medical Consent

Facesheet

Patient Medical History

Upload any prior labs/ med. history

Other forms:

Medication Refill Request

Location

Alla Khalfin, DO
175 Jericho Turnpike, Suite 201
Long Island

Syosset, NY 11791
Phone: 516-206-4266

Office Hours

Get in touch

516-206-4266