Physician Referral Service - Fresh Meadows Appointment Request

Please complete this form if you would like our Physician Referral Service to call you to schedule an appointment with the appropriate HSS physician. Our Physician Referral Service will typically respond within one business day.

You can also request an appointment by calling +718.591.7090 (Monday-Friday 9am-5pm ET).

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Tell us who you are

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Contact Information

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Patient Information

Has the patient had an evaluation or diagnostic testing within the last 6 months?:

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Has a physician told the patient that surgery is needed?:

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