Huntington Medical Group Department Map

     Map

ALL NEW PATIENTS AND INSURANCE UPDATES MUST COMPLETE MAIN REGISTRATION FORMS IN ADDITION TO DEPARTMENT QUESTIONNAIRES:

     Huntington Medical Group Main Registration form (PDF)

Dermatology:

     Dermatology New Patient Form (PDF)

Ear, Nose & Throat:

     ENT Initial Visit Questionnaire (PDF)

Gastroenterology

     Gastroenterology Patient History Form (PDF)

Hematology/Oncology

     Hem Onc Medications and Allergies (PDF)

Internal Medicine (Dr. Wishner & Dr. Perillo):

     Internal Medicine Initial Visit (PDF)

Nephrology:

     Nephrology New Patient (PDF)
     Directions to Nephrology Office

Obstetrics & Gynecology:

     Patient Medical History form (PDF)

Ophthalmology:

     Ophthalmology Patient Health and History Form (PDF)

Orthopaedics:

     Dr. Gurtowski Initial Visit (PDF)
     Dr. Spak Initial Visit (PDF)

Pain Management:

      Pain Management New Patient Form (PDF)

Podiatry:

     New Patient Form (PDF)

Pulmonary:

     Pulmonary Patient History Form (PDF)

Radiology:

      Radiology MRI Questionnaire (PDF)
      Radiology MRI Exam Form (PDF)
      Radiology Patient Pregnancy Form (PDF)
      Radiology CT IV Contrast Consent and Questionnaire Form (PDF)
      Radiology Mammogram Patient Information Questionniare (PDF)
      Radiology Breast MRI Questionnaire (PDF)