Find the patient registration form downloads on this page.
Download and fill out the appropriate registration PDF forms on this page. Bring the completed forms with you to your appointment.
See the forms below. You can either use the “Fillable PDF Forms” to fill in the form fields in your browser and then print. Or, you can use the “Downloadable PDF Forms” to print and then fill out with a pen.
FTCA Deemed Organization – This health center is a Health Center Program grantee under 42 U.S.C 254b, and a deemed Public Health Service employee under 42 U.S.C 233 (g)-(n). Therefore, Long Island Select Healthcare, Inc. (LISH) is granted medical malpractice liability protection through the Federal Tort Claims Act (FTCA), and it’s employees are considered Federal employees with Federal Government acting as their primary insurer.
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