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 New York, New York, welcomes you to our practice. Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to Dr. Raymond Zakhari, NP, visiting you in your home or workplace will help speed up the new patient registration process.

Please be sure to have any diagnostic films or other test results that may have been ordered or performed by another physician.

Interactive Forms: (complete and submit this form BEFORE your first appointment)

Psychiatric Mental Health Survey

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.