(646) 876-9986


This page contains all the forms required for your first visit with Dr. Maura.

New Patient Checklist — Download this form which lists everything we need before your appointment.

New Patient Intake Form — This secure online questionnaire takes 30–40 minutes to complete. If you are unable to access or complete this form online, please contact Dr. Maura via the contact form at the right to request a PDF version.

Pediatric/Adolescent Intake Form — Please print, complete and return this form by fax to 646/360-2844 before your child’s first appointment.

Please print and complete the following two forms, and either return them by fax to 646/360-2844 or bring them to your first visit.
Financial Responsibility Form
Consent Form

Email Policy — Please read Dr. Maura’s policy on email communications.