Bay Ridge Medical Care
Main Location
370 Bay Ridge Pkwy 
Brooklyn NY 11209,
PH (718) 833-4200
Fax (718) 833-0033		 Brooklyn Spine & Arthritis Center
1 Prospect Park West
Brooklyn, NY 11215
(Bet. Union St. & President St.)
P: (718) 833-7246, (718) 833-4200
F: (718) 504-6055, (718) 833-0033		 Brooklyn Spine & Arthritis Center
263 Seventh Avenue
Suite 2B
Brooklyn, NY 11215
P: (718) 833-7246, (718) 833-4200
F: (718) 504-6055, (718) 833-0033 		 Staten Island Location
212 Garretson Avenue
Staten Island, NY 10305
P: (718) 833-7246, (718) 833-4200
F: (718) 504-6055, (718) 833-0033 
Copyright 2012 Dr. Hedayatiyan
NYC
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Patients History

Please let us know your MEDICAL CONDITIONS. To get the format Click Here
Patients Information

Please let us know your details such as "Name, Date of Birth etc..., Also Insurance Details" To get the format Click Here
PCP and Referring Form 

Please let us know the details about you Primary Care Physician (PCP) and Referring Doctor Details. To get the format Click Here
PATIENT'S SIGNATURE ON FILE FORM FOR MEDICAL CLAIMS

Patient's Signature on File Form for Husa telefon ieftina Medical Claims. To get the format Click Here
NO FAULT CASE Patients Only 

NO FAULT CASE Patients Only. To get the format Click Here
Worker’s Compensation Patients Only 

Worker’s Compensation Patients Only. To get the format Click Here
Informed Consent and Medication Use Agreement 

Informed Consent and Medication Use Agreement. To get the format Click Here

"Please call for any additional information regarding referrals, insurance information, and appointments."
"All patients must contact the office to make a valid appointment"
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