775 Park Avenue, Suite 216 | Huntington, NY 11743 | (631) 424-1234

New Patient Forms


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Please prepare for your first appointment by completing our new patient information forms. Download this form to your computer to complete at home. Then bring it with you to your first appointment.

Please read our standard privacy policy document.

These forms are provided for  the convenience of our patients who have undergone surgery.

These documents are in Adobe PDF format. If you're unable to read PDF files, you can download Acrobat Reader free from Adobe.


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Anthony M. Polimeni, DMD, PC
Ste 216, 775 Park Avenue, Huntington, NY 11743 | (631) 424-1234
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