New Patient Forms

All new patients, please complete the following forms prior to your appointment. You can print and email or bring them with you to your appointment. Failure to complete forms beforehand may decrease allotted assessment and treatment time.

1. New Patient Health Form

2. HIPAA & Financial Policy Form

4. Consent Form

3. Insurance Verification

4. Insurance Agreement Forms

If upon completing the forms, there are questions or concerns, please call prior to your appointment time (646) 854-6619.

New Location!

315 W 55th St (btwn 8th & 9th)
New York, NY 10019
Located in office with New York Ayurveda & Panchakarma Center

Contact

Phone (646) 854-6619
Email info@linyanagipson.com

Hours

Saturday & Sunday 11 am - 7 pm
Same day appointments available
House calls available

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