Suffolk Nephrology Consultants P.C.

APPOINTMENT REQUESTS BY PHYSICIANS

Dear Doctors and Health Care Practitioners:

While you can always request office consultations by phone (631) 689-7800 during our office hours, for your convenience we have developed an online appointment request system that may be used at any time.

For online appointment requests:

  • Please fill in patient data below. All fields marked (*) are required.
  • Make sure the patient has the necessary insurance referral required for the office visit.
  • Fax pertinent laboratory tests and imaging studies to our main fax # (631) 689-3016

Referring Physician: *
PATIENT INFORMATION
First and Last Name: *
Date of Birth: *
Home Telephone: *
Cell Phone:
Work Telephone:
Schedule Appointment: New patient consultation
Follow-up appointment
Address information for new patients only, if readily available.
Address:
City:
State:
ZIP Code:
Reason for consultation or follow-up appointment: *
Your information will be processed by clicking this button and treated confidentially.
Please click this button only once.
Appointment requests will be retrieved by our scheduling staff, who will then call your patient to schedule the appointment. Generally, patients will be contacted within 24h. Appointment requests made Friday after 5 PM or over the weekend, will be answered the following business day.

SUFFOLK NEPHROLOGY CONSULTANTS P.C.
2500 Route 347, Bldg. #14A
Stony Brook, NY 11790
Tel: (631) 689-7800
Fax: (631) 689-3016
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