Online Patient Forms

Patient Forms

To save time, please download and complete the above forms before your appointment.

​We look forward to serving you!
Welcome Form
File Size: 6 kb
File Type: pdf
Download File
Medical History Form
File Size: 52 kb
File Type: pdf
Download File
Contact Us
110 lockwood Ave., Suite 104
New Rochelle, NY 10801
Phone: 914-636-5506
Office Hours
Mon    CLOSED
Tue     9:00 am - 6:00 pm
Wed    10:00 am - 7:00 pm
Thu     10:00 am - 5:00 pm
Fri       10:00 am - 3:00 pm
Sat      10:00 am - 3:00 pm

*Dr. Germaine is available for an appointment on Tuesday, Wednesday, Friday or Saturday. 
Notice of Privacy Practices
Website by Eyefinity