If you have an authorization code from our office, you can use that code to access our online Secure Forms Portal to complete your patient forms.
NOTE: The Online Forms Portal only has forms for New and Existing Patients. If you need to access the Worker's Comp forms, please use the pdf file link at the bottom of this page.
To speed up your visit to our office, you may print out these forms (in pdf format) and complete them at your convenience by clicking on the Download links below. Please bring your completed forms with you when you visit our office.
FOR NEW PATIENTS: Choose the 5-page New Patient Information Form
FOR EXISTING PATIENTS: Choose the 3-page Patient Update Form
WORKERS COMP FORMS: Worker's Comp patients who are new must also fill out the New Patients forms.
Please call us for an appointment.
Fax any documents to 631-277-0298.
Union Medical Plaza, 2330 Union Boulevard, Islip, NY 11751, USA
(631) 277-8900 Fax: 631-277-0298 Email: lanceberlin@gmail.com Web: www.lanceberlin.com
Open today | 08:30 am – 08:30 pm |
Open 7 days a week.
24 Hour Emergency Service Available.
Copyright © 2023 - All Rights Reserved.
This website uses cookies. By continuing to use this site, you accept our use of cookies.