patient forms Hauppauge, NY
At The Vitality Center, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax us your printed and completed forms or you may bring them during your visit.

New Patient and Insurance Information Form – Required

Download & Print Form 1

Download & Print Form 2 

New Patient HIPAA Notice – Required 

Download & Print Form 3 

New Patient Health History Form – Required

Download & Print Form 4 

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

If you do not have AdobeReader® installed on your computer, Click Here To Download.