By taking a few minutes to complete this form, you -- or your representative acting on your behalf -- can request an appointment with the EYE or ENT General Care Center at The New York Eye and Ear Infirmary. Once your form is submitted, you should expect a response from our Appointment Desk staff within 48 hours (Monday through Friday.).
This form is not for emergency services. For emergency medical treatment or medical advice concerning specific conditions or treatments, please consult with a qualified health care provider or go to your nearest Hospital Emergency Room.
If you would prefer to make an appointment by phone, please call the Appointment Desk at (212) 979-4192.
|Appointment Request Form|
Patient Information * indicates a required field