By taking a few minutes to complete this form, you -- or your representative acting on your behalf -- can request an appointment with the Ear Institute at New York Eye and Ear Infirmary of Mount Sinai. Once your form is submitted, you should expect a response from our 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 Center for Hearing and Balance Disorders at The Ear Institute directly at (212) 979-4340.
|The Ear Institute Appointment Request Form - Diagnostic Audiology and Balance Testing|
Patient Information * indicates a required field
Center for Hearing & Balance Disorders
at The Ear Institute
New York Eye and Ear Infirmary of Mount Sinai
230 Second Avenue, 2nd Floor
(at 14th Street)
New York, NY 10003
(212) 979-4340 Main Number
(212) 533-3489 FAX