Now accepting Telehealth appointments. Schedule a virtual visit.

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


Patient Medical History

Upload any prior labs/ med. history

Other forms:

Medication Refill Request

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

Syosset, NY 11791
Phone: 516-206-4266
Office Hours

Get in touch