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The Woman’s Health Pavilion
  • About Us
    • Providers
      • Andre Saad, MD, FACOG
      • Stephen E. Scarantino, MD, FACOG
      • Daphne Mercer, MD, FACOG
      • Osasu Asemota, MD, FACOG
      • Frances Anderson, MD, FACOG
      • Neha Egbert, MD, FACOG
      • Lahari Shetty, MD, FACOG
      • Manjiri S. Nadkarni, M.D., M.S. 
      • Maria Kon, MD, PhD, FACOG
      • Nicolette Reese, MD, FACOG
      • Jerald Korman, M.D. FACOG
      • Teresita Santiago, MD, FACOG
      • Stephanie Killeen, MD, FACOG
      • Maggie Yeung, MD
      • Daphney Noel, MD
      • Skyler Barcia, MD
      • Kathleen Tullo, WHNP-BC
      • Brittany Aksnes, MS, PA-C
      • Ashley Funes, MS, PA-C
      • Nicole Hakimi, MS, PA-C
      • Melanie Jackson, FNP-BC
      • Michelle Walsh, MS, PA-C
      • Courtney Haggerty, AGNP-C
      • Lauren Hoo, MS, PA-C
      • Jenna Smith, MS, PA-C
      • Rachel Levine, ANP
      • Keena Gordon (Samuels), DNP, ANP
      • Laura Flanagan, MSN, WHNP-BC
      • Chinara Corey, FNP-C
      • Caitlyn Progebin (O’Neil), MSN, WHNP-BC
      • Victoria Smith, WHNP-BC
      • Melin M. Pérez-Torres, MS, RN, CNM
      • Tiana Miller, MSN, WHNP, RN-BC
      • Kristen Smith, PA-C
      • Tricia A. Singh, RPA-C 
      • Tracey Lhérisson, WHNP
      • Prova Qurashi, PA-C
      • Marissa Scialpi, MSN, WHNP
      • Rivki Fixler RPA-C
      • Debrah Weberman, PA-C
      • Olu Owoyele-Alake, NP-C
      • Sophia Eliassi, PA-C
      • Pegah Gheitani RPA-C
      • Alexandra Kasparian, PA-C 
      • Rosa Munson-Blatt, MSN, WHNP-BC 
      • Ariella Goldsmith PA-C
      • Renee Wisniski, CNM, WHNP-BC
      • Rosie G. Salomon, PA-C
      • Safiyah Khalfan PA-C
      • Margaret Johnson RN, CNM
      • Sana Hira, PA-C
      • Diedre A. Willer, DNP, CNM, WHNP-BC
      • Jamie Razumov – Obstetrical Coordinator
    • Understanding Your OB/GYN Care Providers: MDs, DOs, PAs, NPs, and Midwives
    • Unique Roles Held by Our Medical Providers
    • Clinical Support Staff
    • Urgent Appointments
    • Awards & Recognition
    • Careers
  • Services
    • Well-Woman Care
      • Annual Well-Woman Exam
      • Birth Control Options
    • Obstetrics
      • Quick Guide for Our Maternity Patients
        • Hospital Bag Checklist for Labor & Delivery
      • Prenatal Care
        • Childbirth Class
      • Safe Medications in Pregnancy
      • Prenatal Care FAQ
      • When Labor Begins
      • When Labor Begins FAQ
      • Once in Labor
      • Once in Labor FAQ
      • First Month After Delivery
      • First Month After Delivery FAQ
      • Postpartum Recovery
    • Gynecology
      • Choosing the Right Gynecologist
      • Choosing the Right Gynecologist FAQ
    • Minimally Invasive Gynecologic Surgery
    • Telehealth for OB-GYN Patients
  • Conditions
    • Abnormal Bleeding
      • Abnormal Bleeding FAQ
    • Abnormal Pap/HPV
      • Human Papillomavirus (HPV) FAQ
    • Endometriosis
      • Endometriosis FAQ
    • Fertility Services
    • Fibroids
      • Fibroids FAQ
    • Heavy Periods
      • Heavy Periods FAQ
    • Incontinence
      • Incontinence FAQ
    • Ovarian Cysts
    • Painful Periods
      • Painful Periods FAQ
    • Pelvic Pain
    • Perimenopause and Menopause 
      • Menopause FAQ
    • Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly known as PCOS) 
    • PMS vs. PMDD 
    • Polyps
      • Polyps FAQ
    • Sexually Transmitted Infections (STIs)
      • Herpes Simplex Virus (HSV) FAQ
    • Urinary Tract Infections
      • UTI FAQ
  • Treatments
    • Bioidentical Hormone Replacement Therapy (BHRT)
    • Birth Control Options
      • Birth Control Pills
      • IUD (Intrauterine Device)
      • Permanent Birth Control
    • BOTOX® Cosmetic
    • Endometrial Ablation
    • Laparoscopic Hysterectomy
    • Minimally Invasive Myomectomy
    • Obturator Sling
    • Tubal Sterilization
    • Ultrasounds
  • New Patients
    • Why Choose Us
    • Billing & Insurance
    • Office Policies
    • New Patient Forms
  • Locations
    • Queens
      • Glendale
        • Directions From Cypress Hills
        • Directions From Forest Park
        • Directions From Maspeth
        • Directions From Ocean Hill
      • Howard Beach
        • Directions From Arverne
        • Directions From Hamilton Beach
        • Directions From Ozone Park
        • Directions From South Ozone Park
        • Directions From Richmond Hill
        • Directions from The Rockaways
        • Driving Directions From Wakefield, New York
        • Directions From Woodhaven
      • Forest Hills
        • Directions From Corona
        • Directions From Elmhurst
        • Directions From Glendale
        • Directions From Kew Gardens
        • Directions From Middle Village
        • Directions From Rego Park
    • Long Island
      • Lynbrook
        • Directions From East Rockaway
        • Directions From Hewlett
        • Directions From Lakeview
        • Directions From Malverne
        • Directions From Oceanside
        • Directions From Rockville Centre
        • Directions From Valley Stream
      • Westbury
        • Directions From Hicksville
        • Directions From Jericho
        • Directions From Mineola
        • Driving Directions From New Cassel, New York
        • Directions From Old Westbury
        • Driving Directions From Salisbury, New York
        • Directions From Williston Park
      • Levittown
        • Directions From Bellmore
        • Directions From Bethpage
        • Directions From East Meadow
        • Directions From Farmingdale
        • Driving Directions From Plainedge, New York
        • Directions From Wantagh
      • Massapequa
        • Directions From Amityville
        • Directions From Copiague
        • Directions From South Farmingdale
        • Directions From Wantagh
  • Contact Us
    • Billing & Insurance
    • Privacy Policy
    • Site Map
    • Thank You
  • Search

New Patient Forms

Please click the following links to download individual forms or click the button to download all the forms in a single PDF document.

  • Patient Registration Sheet
  • Instructions for Contacting You
  • Responsibility for Payment
  • Acknowledgement of Receipt of Privacy Practices
  • Pharmacy Information
  • Privacy Policy Statement

Quick Print All Forms

  • About Us
    • Providers
      • Andre Saad, MD, FACOG
      • Stephen E. Scarantino, MD, FACOG
      • Daphne Mercer, MD, FACOG
      • Osasu Asemota, MD, FACOG
      • Frances Anderson, MD, FACOG
      • Neha Egbert, MD, FACOG
      • Lahari Shetty, MD, FACOG
      • Manjiri S. Nadkarni, M.D., M.S. 
      • Maria Kon, MD, PhD, FACOG
      • Nicolette Reese, MD, FACOG
      • Jerald Korman, M.D. FACOG
      • Teresita Santiago, MD, FACOG
      • Stephanie Killeen, MD, FACOG
      • Maggie Yeung, MD
      • Daphney Noel, MD
      • Skyler Barcia, MD
      • Kathleen Tullo, WHNP-BC
      • Brittany Aksnes, MS, PA-C
      • Ashley Funes, MS, PA-C
      • Nicole Hakimi, MS, PA-C
      • Melanie Jackson, FNP-BC
      • Michelle Walsh, MS, PA-C
      • Courtney Haggerty, AGNP-C
      • Lauren Hoo, MS, PA-C
      • Jenna Smith, MS, PA-C
      • Rachel Levine, ANP
      • Keena Gordon (Samuels), DNP, ANP
      • Laura Flanagan, MSN, WHNP-BC
      • Chinara Corey, FNP-C
      • Caitlyn Progebin (O’Neil), MSN, WHNP-BC
      • Victoria Smith, WHNP-BC
      • Melin M. Pérez-Torres, MS, RN, CNM
      • Tiana Miller, MSN, WHNP, RN-BC
      • Kristen Smith, PA-C
      • Tricia A. Singh, RPA-C 
      • Tracey Lhérisson, WHNP
      • Prova Qurashi, PA-C
      • Marissa Scialpi, MSN, WHNP
      • Rivki Fixler RPA-C
      • Debrah Weberman, PA-C
      • Olu Owoyele-Alake, NP-C
      • Sophia Eliassi, PA-C
      • Pegah Gheitani RPA-C
      • Alexandra Kasparian, PA-C 
      • Rosa Munson-Blatt, MSN, WHNP-BC 
      • Ariella Goldsmith PA-C
      • Renee Wisniski, CNM, WHNP-BC
      • Rosie G. Salomon, PA-C
      • Safiyah Khalfan PA-C
      • Margaret Johnson RN, CNM
      • Sana Hira, PA-C
      • Diedre A. Willer, DNP, CNM, WHNP-BC
      • Jamie Razumov – Obstetrical Coordinator
    • Understanding Your OB/GYN Care Providers: MDs, DOs, PAs, NPs, and Midwives
    • Unique Roles Held by Our Medical Providers
    • Clinical Support Staff
    • Urgent Appointments
    • Awards & Recognition
    • Careers
  • Services
    • Well-Woman Care
      • Annual Well-Woman Exam
      • Birth Control Options
    • Obstetrics
      • Quick Guide for Our Maternity Patients
        • Hospital Bag Checklist for Labor & Delivery
      • Prenatal Care
        • Childbirth Class
      • Safe Medications in Pregnancy
      • Prenatal Care FAQ
      • When Labor Begins
      • When Labor Begins FAQ
      • Once in Labor
      • Once in Labor FAQ
      • First Month After Delivery
      • First Month After Delivery FAQ
      • Postpartum Recovery
    • Gynecology
      • Choosing the Right Gynecologist
      • Choosing the Right Gynecologist FAQ
    • Minimally Invasive Gynecologic Surgery
    • Telehealth for OB-GYN Patients
  • Conditions
    • Abnormal Bleeding
      • Abnormal Bleeding FAQ
    • Abnormal Pap/HPV
      • Human Papillomavirus (HPV) FAQ
    • Endometriosis
      • Endometriosis FAQ
    • Fertility Services
    • Fibroids
      • Fibroids FAQ
    • Heavy Periods
      • Heavy Periods FAQ
    • Incontinence
      • Incontinence FAQ
    • Ovarian Cysts
    • Painful Periods
      • Painful Periods FAQ
    • Pelvic Pain
    • Perimenopause and Menopause 
      • Menopause FAQ
    • Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly known as PCOS) 
    • PMS vs. PMDD 
    • Polyps
      • Polyps FAQ
    • Sexually Transmitted Infections (STIs)
      • Herpes Simplex Virus (HSV) FAQ
    • Urinary Tract Infections
      • UTI FAQ
  • Treatments
    • Bioidentical Hormone Replacement Therapy (BHRT)
    • Birth Control Options
      • Birth Control Pills
      • IUD (Intrauterine Device)
      • Permanent Birth Control
    • BOTOX® Cosmetic
    • Endometrial Ablation
    • Laparoscopic Hysterectomy
    • Minimally Invasive Myomectomy
    • Obturator Sling
    • Tubal Sterilization
    • Ultrasounds
  • New Patients
    • Why Choose Us
    • Billing & Insurance
    • Office Policies
    • New Patient Forms
  • Locations
    • Queens
      • Glendale
        • Directions From Cypress Hills
        • Directions From Forest Park
        • Directions From Maspeth
        • Directions From Ocean Hill
      • Howard Beach
        • Directions From Arverne
        • Directions From Hamilton Beach
        • Directions From Ozone Park
        • Directions From South Ozone Park
        • Directions From Richmond Hill
        • Directions from The Rockaways
        • Driving Directions From Wakefield, New York
        • Directions From Woodhaven
      • Forest Hills
        • Directions From Corona
        • Directions From Elmhurst
        • Directions From Glendale
        • Directions From Kew Gardens
        • Directions From Middle Village
        • Directions From Rego Park
    • Long Island
      • Lynbrook
        • Directions From East Rockaway
        • Directions From Hewlett
        • Directions From Lakeview
        • Directions From Malverne
        • Directions From Oceanside
        • Directions From Rockville Centre
        • Directions From Valley Stream
      • Westbury
        • Directions From Hicksville
        • Directions From Jericho
        • Directions From Mineola
        • Driving Directions From New Cassel, New York
        • Directions From Old Westbury
        • Driving Directions From Salisbury, New York
        • Directions From Williston Park
      • Levittown
        • Directions From Bellmore
        • Directions From Bethpage
        • Directions From East Meadow
        • Directions From Farmingdale
        • Driving Directions From Plainedge, New York
        • Directions From Wantagh
      • Massapequa
        • Directions From Amityville
        • Directions From Copiague
        • Directions From South Farmingdale
        • Directions From Wantagh
  • Contact Us
    • Billing & Insurance
    • Privacy Policy
    • Site Map
    • Thank You
Request an Appointment

Glendale

(718)577-4747


Lynbrook

(516)881-9560


Howard Beach

(718) 843-6300


Westbury

(516) 333-1444


Forest Hills

(718) 263-1963


Levittown

(516) 731-9000


Massapequa

(516) 799-4500

Message Us

Woman's Health Pavilion Locations

Glendale

(718)577-4747(718)577-4747

73-09 Myrtle Avenue
Glendale, NY 11385
Fax: (718) 577-4744

The Woman's Health Care Center - Glendale

Lynbrook

(516)881-9560(516)881-9560

158 Hempstead Avenue
Lynbrook, NY 11563
Fax: (516) 881-9561

The Woman's Health Care Center - Lynbrook

Howard Beach

(718) 843-6300(718) 843-6300

82-12 151st Avenue
Howard Beach, NY 11414
Fax: (718) 843-6334

The Woman's Health Pavilion Howard Beach

Westbury

(516) 333-1444(516) 333-1444

372 Post Avenue
Westbury, NY 11590
Fax: (516) 333-2725

The Woman's Health Pavilion Westbury

Forest Hills

(718) 263-1963(718) 263-1963

109-33 71st Road, Suite 2G
Forest Hills, NY 11375
Fax: (718) 268-6616

The Woman's Health Pavilion Forest Hills

Levittown

(516) 731-9000(516) 731-9000

2950 Hempstead Turnpike
Levittown, NY 11756
Fax: (516) 731-9004

The Woman's Health Pavilion Letittown

Massapequa

(516) 799-4500(516) 799-4500

514 Ocean Avenue
Massapequa, NY 11758
Fax: (516) 799-4570

The Women's Health Care Center
  • Privacy Policy
  • Site Map
  • Contact Us

Copyright © 2026 The Woman's Health Pavilion. All rights reserved.

AAGL Center of Excellence in Minimally Invasive Gynecology Logo Best of Long Island Logo
  • About Us
    • Providers
      • Andre Saad, MD, FACOG
      • Stephen E. Scarantino, MD, FACOG
      • Daphne Mercer, MD, FACOG
      • Osasu Asemota, MD, FACOG
      • Frances Anderson, MD, FACOG
      • Neha Egbert, MD, FACOG
      • Lahari Shetty, MD, FACOG
      • Manjiri S. Nadkarni, M.D., M.S. 
      • Maria Kon, MD, PhD, FACOG
      • Nicolette Reese, MD, FACOG
      • Jerald Korman, M.D. FACOG
      • Teresita Santiago, MD, FACOG
      • Stephanie Killeen, MD, FACOG
      • Maggie Yeung, MD
      • Daphney Noel, MD
      • Skyler Barcia, MD
      • Kathleen Tullo, WHNP-BC
      • Brittany Aksnes, MS, PA-C
      • Ashley Funes, MS, PA-C
      • Nicole Hakimi, MS, PA-C
      • Melanie Jackson, FNP-BC
      • Michelle Walsh, MS, PA-C
      • Courtney Haggerty, AGNP-C
      • Lauren Hoo, MS, PA-C
      • Jenna Smith, MS, PA-C
      • Rachel Levine, ANP
      • Keena Gordon (Samuels), DNP, ANP
      • Laura Flanagan, MSN, WHNP-BC
      • Chinara Corey, FNP-C
      • Caitlyn Progebin (O’Neil), MSN, WHNP-BC
      • Victoria Smith, WHNP-BC
      • Melin M. Pérez-Torres, MS, RN, CNM
      • Tiana Miller, MSN, WHNP, RN-BC
      • Kristen Smith, PA-C
      • Tricia A. Singh, RPA-C 
      • Tracey Lhérisson, WHNP
      • Prova Qurashi, PA-C
      • Marissa Scialpi, MSN, WHNP
      • Rivki Fixler RPA-C
      • Debrah Weberman, PA-C
      • Olu Owoyele-Alake, NP-C
      • Sophia Eliassi, PA-C
      • Pegah Gheitani RPA-C
      • Alexandra Kasparian, PA-C 
      • Rosa Munson-Blatt, MSN, WHNP-BC 
      • Ariella Goldsmith PA-C
      • Renee Wisniski, CNM, WHNP-BC
      • Rosie G. Salomon, PA-C
      • Safiyah Khalfan PA-C
      • Margaret Johnson RN, CNM
      • Sana Hira, PA-C
      • Diedre A. Willer, DNP, CNM, WHNP-BC
      • Jamie Razumov – Obstetrical Coordinator
      • Back
    • Understanding Your OB/GYN Care Providers: MDs, DOs, PAs, NPs, and Midwives
    • Unique Roles Held by Our Medical Providers
    • Clinical Support Staff
    • Urgent Appointments
    • Awards & Recognition
    • Careers
    • Back
  • Services
    • Well-Woman Care
      • Annual Well-Woman Exam
      • Birth Control Options
      • Back
    • Obstetrics
      • Quick Guide for Our Maternity Patients
        • Hospital Bag Checklist for Labor & Delivery
        • Back
      • Safe Medications in Pregnancy
      • Prenatal Care FAQ
      • When Labor Begins FAQ
      • Once in Labor FAQ
      • First Month After Delivery
      • First Month After Delivery FAQ
      • Postpartum Recovery
      • Back
    • Gynecology
      • Choosing the Right Gynecologist
      • Choosing the Right Gynecologist FAQ
      • Back
    • Minimally Invasive Gynecologic Surgery
    • Telehealth for OB-GYN Patients
    • Back
  • Conditions
    • Abnormal Bleeding
      • Abnormal Bleeding FAQ
      • Back
    • Abnormal Pap/HPV
      • Human Papillomavirus (HPV) FAQ
      • Back
    • Endometriosis
      • Endometriosis FAQ
      • Back
    • Fertility Services
    • Fibroids
      • Fibroids FAQ
      • Back
    • Heavy Periods
      • Heavy Periods FAQ
      • Back
    • Incontinence
      • Incontinence FAQ
      • Back
    • Ovarian Cysts
    • Painful Periods
      • Painful Periods FAQ
      • Back
    • Pelvic Pain
    • Perimenopause and Menopause 
      • Menopause FAQ
      • Back
    • Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly known as PCOS) 
    • PMS vs. PMDD 
    • Polyps
      • Polyps FAQ
      • Back
    • Sexually Transmitted Infections (STIs)
      • Herpes Simplex Virus (HSV) FAQ
      • Back
    • Urinary Tract Infections
      • UTI FAQ
      • Back
    • Back
  • Treatments
    • Bioidentical Hormone Replacement Therapy (BHRT)
    • Birth Control Options
      • Birth Control Pills
      • IUD (Intrauterine Device)
      • Permanent Birth Control
      • Back
    • BOTOX® Cosmetic
    • Endometrial Ablation
    • Laparoscopic Hysterectomy
    • Minimally Invasive Myomectomy
    • Obturator Sling
    • Tubal Sterilization
    • Ultrasounds
    • Back
  • New Patients
    • Why Choose Us
    • Billing & Insurance
    • Office Policies
    • New Patient Forms
    • Back
  • Locations
    • Queens
      • Glendale
        • Directions From Cypress Hills
        • Directions From Forest Park
        • Directions From Maspeth
        • Directions From Ocean Hill
        • Back
      • Howard Beach
        • Directions From Arverne
        • Directions From Hamilton Beach
        • Directions From Ozone Park
        • Directions From South Ozone Park
        • Directions From Richmond Hill
        • Directions from The Rockaways
        • Driving Directions From Wakefield, New York
        • Directions From Woodhaven
        • Back
      • Forest Hills
        • Directions From Corona
        • Directions From Elmhurst
        • Directions From Glendale
        • Directions From Kew Gardens
        • Directions From Middle Village
        • Directions From Rego Park
        • Back
      • Back
    • Long Island
      • Lynbrook
        • Directions From East Rockaway
        • Directions From Hewlett
        • Directions From Lakeview
        • Directions From Malverne
        • Directions From Oceanside
        • Directions From Rockville Centre
        • Directions From Valley Stream
        • Back
      • Westbury
        • Directions From Hicksville
        • Directions From Jericho
        • Directions From Mineola
        • Driving Directions From New Cassel, New York
        • Directions From Old Westbury
        • Driving Directions From Salisbury, New York
        • Directions From Williston Park
        • Back
      • Levittown
        • Directions From Bellmore
        • Directions From Bethpage
        • Directions From East Meadow
        • Directions From Farmingdale
        • Driving Directions From Plainedge, New York
        • Directions From Wantagh
        • Back
      • Massapequa
        • Directions From Amityville
        • Directions From Copiague
        • Directions From South Farmingdale
        • Directions From Wantagh
        • Back
      • Back
    • Back
  • Contact Us
    • Billing & Insurance
    • Back