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]


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