Patient Forms

Before receiving care as a patient at NYU Langone, we ask that you review or sign several forms to make sure that you understand your rights and responsibilities.

Woman Reviewing Phone

Prior to your hospital stay or doctor’s visit, forms and notices you need to review or sign are posted in your NYU Langone Health MyChart account. If you are a patient at NYU Langone and do not have a MyChart account, you can create an account. We also recommend that you download the NYU Langone Health app to access your MyChart account from your mobile device.

Download the NYU Langone Health App on the App Store or Google Play.

 

You can read and sign forms in advance of your visit in order to expedite your check-in process.

Review the patient notices and information for the following types of visits:

Request and Share Your Medical Records

You can request your medical records and share them with anyone you authorize, such as a healthcare professional, family member, or legal professional. Learn more about requesting your medical records.

Types of Visits

You may be coming to NYU Langone for a doctor’s office appointment or for a hospital stay as an inpatient, outpatient, or for observation. The forms you need to fill out vary depending on the type of visit, which include the following:

  • An inpatient stay at a hospital, which usually lasts more than two nights, often for surgery, medical treatments, or to stabilize a serious illness or injury.
  • An outpatient stay, which may take place at a hospital or one of our outpatient care centers, where you may have tests, a variety of treatments, or minor surgery. The stay is typically a few hours.
  • Observation, which is a specific kind of outpatient care. People under observation remain in a hospital bed while being monitored for a serious change in their medical condition, usually for less than 24 hours. During that time, a healthcare team decides if the patient needs to be admitted to the hospital.
  • A visit to a doctor’s office to receive care from a physician or another medical professional.

Forms for Your First Visit

During your first visit to an NYU Langone facility, including a hospital, care location, or doctor’s office where the NYU Langone logo is displayed, you need to read and sign the Patient Privacy and HIPAA Rights forms. This information, along with our Health Information Exchange Fact Sheet and Consent Form, is also available in multiple languages. Learn more about HIPAA patient privacy information.

For your safety, we use the PatientSecure® system. With biometric technology, the system scans a unique feature of your hand to simplify patient registration and provide the most accurate form of patient identification for future visits to NYU Langone.

Information for Your Inpatient Visit

People coming for an inpatient stay may need to review these notices and information:

We also provide inpatient forms in several languages, including Chinese, English, Haitian–Creole, Italian, Korean, Russian, and Spanish.

Information for Your Outpatient Visit

In addition, people coming for an outpatient visit need to review the following forms and information:

We also provide outpatient forms in several languages, including Chinese, English, Haitian–Creole, Italian, Korean, Russian, and Spanish.

Notice for Your Observation Visit

People coming for an observation visit need to review the following notice:

Forms for Visits to a Doctor’s Office

If you are a patient who has not yet been to an NYU Langone doctor’s office, you can review the registration forms below in advance of your first office visit to help expedite the initial registration process.

Please call your doctor’s office if you have questions about the forms.

Additional Forms for Doctor’s Office Visits

Review these additional forms that you may need during the course of your treatment at NYU Langone: