Request an Appointment / Patient Forms

Patient Care Centers looks forward to having you join our host of satisfied patients. We have three convenient locations in Teaneck, Paterson and North Bergen, New Jersey. To schedule an appointment, please call the office you wish to visit or use our secure online appointment request form below. Our appointment scheduler will respond to your request within 48 hours.

Please do not use this form if you have an urgent medical problem or you need to reschedule an appointment. Instead, please contact the office you normally visit or at which you have an existing appointment. Be sure to bring any diagnostic films or other test results that may have been ordered or performed by another physician.

Request an Appointment

If you are a new patient, you can pre-register by downloading and printing the new patient forms below.  Please fill them out and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process and get you in to see the doctor faster.

Downloadable Forms:

• New Patient Packet
• Medical Record Release Form