Existing Patient Form

Existing Patient – Contact Form

Thank you very much for contacting Long Island Spine Specialists.
If you are experiencing a medical emergency, please dial 911 or go to the nearest emergency room.
To schedule a follow‐up appointment – this form is for existing patients only ‐ please fill out the form below.
For all other inquiries, please call us during business hours. Monday through Thursday from 8:30am to 5pm and Fridays from 8:30am to 4:30pm.
Please note:  Starting 9/15/20, we now accept all Blue Cross Blue Shield insurance plans. As of 10/1/2019 we will no longer accept HIP, GHI or Healthcare Partners HCP. Any patients having these insurance plans need to touch base with their insurance carriers to obtain information about alternative providers. We apologize for the inconvenience.

Name *

First

Last

Email *

Date of Birth *

Phone *

Preferred Physician *Preferred Physician*Dr. Thomas DowlingDr. Laurence MermelsteinDr. Hargovind DeWalDr. Sushil BasraDr. Christopher FrendoDr. Daniel E. ChoiDr. Joseph SanelliDr. Arjang AbbasiDr. Neal FrauwirthNo Preference

Reason for Inquiry *Reason for Your Inquiry:*Follow-Up Appointment RequestPrescription RefillPost-Surgery QuestionPrescription for Physical TherapyOther

Other *

Mailing ListJoin Our Mailing List?YesNo

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