115 East 61st Street Suite 7C New York, NY 10065 212-980-2600

Patient Forms

To help expedite your appointment process please download the patient forms below by clicking on the links and filling them prior to your appointment. Please bring the filled out forms with you to your appointment.

Patient Insurance (Demographics) Form

Assignment of Benefits Authorization Form

Patient Health Questionnaire

Patient Insurance Coverage Agreement

Practice Acknowledgement Form – By signing this form you have read and accepted the HIPAA Notice of Privacy Practice below.

HIPAA Notice of Privacy Practice

TMJ (Temporomandibular Joint Disorder) Handout


Meet Dr. Garrett Bennett

Learn more about New York City's double board certified Sinus and Nasal Surgery Expert. 

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