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Island Rheumatology

and Osteoporosis, PC

Office of Dr. Sanjay Godhwani

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TeleHealth

6144 Route 25A 

Building C, Suite 13

Wading River, NY 11792

Phone: 631-886-2844

Fax: 631-886-2842

New Location Now Open! - 10 Roosevelt Ave. Port Jefferson Station, NY 11776 

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    NEW PATIENT PACKET
    NEW PATIENT PACKET
    ONLINE PATIENT PORTAL
    New Patient Intake Form
    New Patient Intake Form
    Assignment of benefits.pdf
    Assignment of benefits.pdf
    Referral Form .pdf
    Referral Form .pdf
    TELEMEDICINE CONSULTATION FORM.pdf
    TELEMEDICINE CONSULTATION FORM.pdf
    HIPPA FORM.pdf
    HIPPA FORM.pdf
    Office Policies
    Office Policies
    Medical Release.pdf
    Medical Release.pdf
    Acknowledgemet of policies.pdf
    Acknowledgemet of policies.pdf
    Credit Card Authorzation
    Credit Card Authorzation

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    6144 Route 25A 

    Building C, Suite 13

    Wading River, NY 11792

    Phone: 631-886-2844

    Fax: 631-886-2842

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