Request A Follow-Up Appointment.

New patients: Please Click ‘New consultations’ in Banner Above.

Complete the following form to request an appointment for the appropriate clinician. Our Patient Coordinator will be in contact with you shortly. You can also request an appointment by emailing pc@myfhany.com directly or calling 914-428-8563 ext 2.

Clinician Requested

Clinician being requested (or select any)

Office of Interest

Appointment Type

In-person, virtual (doxy.me) or phone? New consultations are best in person

Patient Name

First Name

Last Name

Patient Date of Birth

YYYY

Email Address

Your Name

First Name

Last Name

Telephone Number

(###)

###

####