The following forms may be completed online, or downloaded, completed, and returned to me at salzermd@me.com
Do you have Oxford, Oscar or United Healthcare? If so, please contact the office at (917) 576-6991 prior to signing up or completing forms to see if we have room for that type of appointment.
- Intake Form
- Teletherapy Consent Form
- HIPAA Form – please only return page 1
- Oxford Claim Form – please only complete if you have Oxford insurance
- Release of Information – please complete only if you wish us to communicate with your previous care provider or a family member