Patient Portal and Office Forms

In an effort to be paperless as well as optimize office hygiene in light of COVID-19, new existing and patients may use the Patient Portal to fill out Online Forms.

For your convenience, PDF forms are also included below to view or use alternatively.

The COVID Health Questionnaire is REQUIRED < 24hrs. prior to EACH scheduled appointment. Telehealth Consent is required to utilize electronic/remote services. A signed copy of the COVID Office Guidelines is required for both existing and new patients.

Thank you for your cooperation and understanding. #flattenthecurve

- Dr. Whitney

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© WHITNEY R. MOSTAFIZ, DMD, MS, P.C., 2020. ALL RIGHTS RESERVED.

DR. WHITNEY R. MOSTAFIZ |BOARD CERTIFIED ORTHODONTIST | 121 E 60 ST STE. 1C NY, NY 10022| (646) 397-6808 | WHITNEY@DRWHITNEYORTHO.COM