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City Integrative Rehabilitation logoCity Integrative Rehabilitation site icon
  • About
    • Our Story
    • Meet the Team
    • Blog
    • Careers
  • Services
    • Sport Rehabilitation
      • Chiropractic Care
      • DNS
      • Anatomy in Motion
    • VAX-D Spinal Decompression
    • Shockwave Therapy
    • Personal Injury
    • Men’s Health
    • House Calls
    • Corporate Wellness
  • Conditions
  • Locations
    • Manhattan
    • Great Neck
    • West Hills
    • Nesconset (Coming Soon)
  • Book Now

Patient Intake Forms

Please select the form that matches your visit type. Complete your paperwork online before your appointment to save time.

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Major Medical & Cash

For patients with health insurance coverage or self-pay visits

Complete Intake Form →
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Auto Accident

For patients seeking treatment related to a motor vehicle accident

Complete Intake Form →

Not sure which form to fill out? Call us at (212) 760-3456 and we’ll help you out.

At CityIR, we don't chase pain, we eliminate it.

About UsAll ServicesMeet the TeamAppointmentsContact UsIntake Paperwork

Manhattan

(646) 256-9513Mon–Thu: 7–8pm | Fri: 7–5pm | Sat: By appt

Great Neck

(516) 418-3798Mon/Wed/Fri: 8–6pm | Tue/Thu: 8–1pm

West Hills

(631) 659-2980Mon–Fri: 7–7pm | Sat: 7–12pm

*Appointment Only | *Emergency visits available

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  • Meet the Team
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  • Contact Us
  • Intake Paperwork

Business Hours

Manhattan(646) 256-9513Mon–Thu: 7–8pm
Fri: 7–5pm | Sat: By appt
Great Neck(516) 418-3798Mon/Wed/Fri: 8–6pm
Tue/Thu: 8–1pm
West Hills(631) 659-2980Mon–Fri: 7–7pm
Sat: 7–12pm

*Appointment Only | *Emergency visits available

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