Get in touch with New York Pain Management.

Don’t wait any longer, send us your Appointment Request today. Please fill out the short contact form below. Be sure to hit the Submit button after completing the form. We look forward to hearing from you and will be in touch soon.

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Only patient inquiries are accepted via this website. For all other inquiries and information, please call our main number.

Patient Forms

Once you have set up an appointment with NY Pain Management, you will need to complete our New Patient Paperwork. You can now get a head start by completing your initial paperwork at home. For your convenience, our required New Patient forms are available online in Adobe® PDF format. Once you download the forms from the link below, you have the following options:

  • Fax: You can complete the forms and then fax to 518-371-0366.
  • Hand Deliver: Simply bring the completed forms with you for your visit.

Having all of your forms completed before your first visit allows the office to remain on schedule as a courtesy to you and our other patients.

PLEASE NOTE: If you are seeing us in relation to a Motor Vehicle Accident or Workers’ Compensation, please download and complete the New Patient Forms AND the Motor Vehicle Accident form or the Workers’ Compensation form.

New Patient Packet

Please print and complete this packet prior to your visit to our office.

No Fault Packet

Please print and complete this form if you are using no fault insurance.

HIPAA

New York Pain Management – Notice of Privacy Practices

Workers’ Compensation Form

If you are seeing us in relation to Workers’ Compensation, please use this form along with the New Patient Form.

Medical Record Release Form

Use this to release your medical records from New York Pain Management to another party as necessary.

If you have any questions, please call us at 518-371-0777.

Thank you for your cooperation and we look forward to seeing you in our office.

Things you should bring to your first appointment:

Please arrive 30 minutes prior to your appointment so we can prepare your chart.
  • Insurance card
  • Picture ID
  • Co/pay co/insurance
  • Films (i.e. MRI, XRAYS) The actual film, not just the report
  • You should have your RECENT X-RAYS AND /OR MRI’S FOR THE DOCTOR TO VIEW.
  • All workers compensation and no-fault patients should have ALL their case and policy numbers and the name and phone number of a contact person. You must also bring in your private insurance information to be placed on file and a referral if applicable.
  • Please arrive on time. For confirmation, we will call you 24-48 hrs. prior to your appt. If you are not available, but have an answering machine, we will leave a message. If we cannot contact you for any reason, i.e. your phone is disconnected; we will cancel your appt. and fill that time with another patient.
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