Patient Information Forms

Patient Information Forms

If this is your first time visiting our office, or if you have not been seen by one of our physicians for more than 2 years, you will need to complete our patient demographic, history and HIPAA forms.

These forms may now be filled out electronically be clicking on the link below and entering our secure Patient Portal:
HTTPS://209.48.65.2/portal/

If you prefer to print the forms and bring them with you to your visit, click on the appropriate links below, (Links will open in a new window.)

If you choose to complete the forms in the office YOU MUST ARRIVE 20 MINUTES PRIOR TO YOUR SCHEDULED APPOINTMENT TIME in order to keep your scheduled appointment time.

We thank you for your anticipated co-operation.

If you are scheduled to see Dr. Varma for a back or neck problem please complete the necessary forms below.

If you are involved in a Workers Compensation claim or a No-Fault claim (motor vehicle accident), please complete the appropriate additional forms:

What to bring to your appointment

  • All of your health insurance cards
  • Physician referrals
  • If applicable, please bring prior X-rays, MRI studies, or previous operative notes.
  • Workers Compensation / No-Fault claims: Please bring all appropriate paperwork to prevent delays.

Still, have questions? Contact us or visit our frequently asked questions page.

At Manhattan Orthopedics, our team of board-certified orthopedic surgeons is dedicated to providing our patients with personalized, comprehensive orthopedic and rehabilitation care.

CONTACT US

57 West 57th Street, 15th Fl
New York, NY 10019
212.289.0700

27-31 Crescent Street
Long Island City, NY 11102
718.204.0548