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Registration Form

Open the new patient registration form as a fillable PDF, complete it digitally or print it, and choose the submission method that works best for you.

Open the Fillable PDF

Use the form online, save a copy for yourself, or print it before your visit if that is easier for you.

If your browser supports it, you can fill in the PDF directly. You can also print it and complete it by hand.

Choose How to Submit It

You may use whichever method is most convenient for you before your first visit.

Bring it to the office
You may submit the completed form in person at the front desk when you arrive.
Fax it to the clinic
Fax completed forms to 516-706-3880.
Email it
You may email the completed form to the clinic if that is easier for you. contact@drouyangcare.com
Complete it at the front desk
If you prefer, you can also complete the registration form in person at the front desk before the visit begins.

Questions Before Your First Visit?

If you are unsure which submission method to use, or want to double-check office details before arriving, the Contact page has the clinic address, phone, fax, email, and office hours in one place.