Call: 631-656-0472

CPH Patients

CPH Patients

Committee for Physicians Health Patients

Release of Information Form – All clients referred by the Committee for Physician Health (CPH) must complete this release and return it to the office prior to their scheduled appointment.
Attn: CPH Coordinator
1717 Veteran’s Memorial Hwy, Ste 2
Islandia, NY 11749
Fax: 631-656-0634 – Please include your name and date of your appointment on the cover sheet.

New Patient Information Form

Utilizing an integrative model to improve health and well-being

Long Island Behavioral Medicine


1717 Veteran's Memorial Highway (Rt. 454), Suite 2
Islandia, NY 11749