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Patient Forms

If this is your first visit with us, please take a moment to read and complete the two items below. You may either save and email, fax or bring with you to your initial consultation. This allows us to spend more time discussing your complaint and less time gathering information.


Step 1: Click to download the new patient information packet

New Patient Information Packet

which you can fill out and save using any PDF program.  It provides you with all the paperwork you need to join our practice , then:


Step 2: Click to download the medical questionnaire

Medical Questionnaire

which you can fill out and save using any PDF program. It helps you to begin the information gathering process.


Step 3: For your convenience, you may email both files to or fax them to 212-682-6979 before your visit.

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happy patient

After two complicated back surgeries in the early seventies I continued to suffer excruciating lower back and sciatic pain. I sought out the finest doctors and rehab facilities. I was very fortunate to have access to some of the best treatment available. Nothing resolved my pain issues until I met Dr. Andre Panagos.  Dr. Panagos discovered the source of my pain when no one else could and treated it with an innovative technique several months ago. I am now pain free for the first time in more than thirty years. He is a compassionate, friendly and open minded physician dedicated to resolving the pain and suffering of his patients.
There are no words to describe my appreciation to this wonderful man and his extraordinary team.

Richard N

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