Download Forms

The following registration form is for new records review and evaluation cases only. Please do not register if you are an existing Dr.Seckin's patient (current or any year prior) or have (or plan to schedule) an in-office appointment.

If you are an existing DrSeckin's patient (from any year) in need of assistance, again, please do not register.
Please call us at 212-988-1444 and we'll be delighted to help you.

If you were looking to book an in-office appointment (fees apply), please note appointments are not made online.

Call us at 212-988-1444 and our staff will be delighted to book you and review the costs/insurance aspects with you. Again, please do not complete this registration form if you are not undergoing the free records evaluation and phone consult process. Thank you.

Here are the forms you will need to download and fill in after you have made an appointment and before your first visit. This will cut down on the time you will need to spend in our offices and it will also allow Dr. Seckin to review your history prior to meeting with you.

   Health History Questionaire >
   Online Registration Form >
   Notice of Privacy Practices >

If you have any questions about how to fill in these form, our staff will be glad to help. Please contact us at [email protected]

 

<< Previous Article
Costs and Insurance Coverage
Costs and Insurance Coverage

We understand that insurance and cost coverage is a concern that is often on the backs of our patients’ minds.…

Read more >

Reviews

  • Kim Molinaro

    Kim Molinaro

    Prior to meeting Dr. Seckin and reading his book, “The Doctor Will See You Now”, I knew little to nothing about endometriosis. I was led to believe that endometriosis was not a serious condition. I was told that the pain could be managed by taking the “pill”. I was told that the cysts on my ovaries were harmless. I was…

  • Rebecca Black

    Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…