Online Forms

Dr. Loren Marks offers our patient forms online so they can be completed in the convenience of your own home or office before your scheduled visit.

  • Please fill out the forms online by clicking the link below or print out the forms and bring them into the office.
  • Filling out forms online is the preferred method.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.


Forms to Fill Out Online

Patient intake Forms

Custom Comment Form


Intake Forms

1. Fill out the online intake forms
2. Download and print and fax or email back part 2.

Please print the appropriate forms for your visit, fill them out and bring them to your visit to expedite your waiting room time. If you’d like, you can even email them to us at [email protected] or fax to 212 399 9659

We look forward to making your experience with our office and website more interactive and rewarding!

Patient Registration Forms -  Download & Print Form

Metabolic Assessment Form (Nutrition Patients) -  Download & Print Form

Notice of Privacy Practices- Please sign the receipt and attach to your New Patient Forms

Keep The Notice of Privacy Practices for your recordsDownload & Print Form 

Contact Us

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Our Location

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Office Hours

Find Out When We Are Open

Monday:

10:00 am-7:00 pm

Tuesday:

10:00 am-7:00 pm

Wednesday:

Closed

Thursday:

10:00 am-7:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed