Telemedicine Appointment Form

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M-F 6-9 p.m., Friday 9 am - 7 pm, Sat 11-7 p.m. VISITS BY APPOINTMENT ONLY! 230 Hilton Ave, Hempstead NY 11550. From the Hempstead Bus Terminal! Go to Jackson St, turn right on Franklin St, left on Atlantic Ave, then right on Hilton Ave.The clinic is at 230 Hilton Ave, Suite 105. COMPLETE THE JOT-FORM BELOW
Clinic Visit [Annual physical, Employment Physical, School physical, Routine Visits]Home Visit or on Telephone visit [Med refill, Fall, Cough, Sore-throat, Urinary issues]DOH, M11Q, NYIA Assessment forms, Employment Physical FormsIntravenous Infusion Therapy
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