Request an Appointment

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our administrative office at (917) 484-2709. After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete.

Patient Registration Forms

Metro Medical Direct in Manhattan, New York welcomes you to our practice. Once you have made your initial appointment, you may pre-register online by completing the interactive form(s) below and/or you may download and print the form(s), fill them out, and have them ready for your first visit. Completing the forms prior to your appointment will help speed up the new patient registration process.

Also, be sure to have any diagnostic films or other test results that may have been ordered or performed by another provider.

Interactive Forms:

Downloadable Forms:

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

Get Adobe Reader

Disclaimer: If you register, make an appointment, or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.

Metro Medical Direct