CLICK HERE TO ACCESS OUR CONSULTATION REQUEST FORM. 

We request that you fill out this information ahead of time so that we may determine if your insurance will cover TMS.

 

This form will automatically come to our office through our HIPAA-secure portal when you submit the form at the bottom.

 

Alternatively, you can print the form out and fax the filled out form to our HIPPA-secure fax line at 212-243-1451.

If you need assistance with this process, please call our office at 212-647-9187.

37 Washington Square West Suite 1D

(C) Copyright 2020 by Shelly Menolascino MD.  All Rights Reserved.

Diplomate of the American Board of Psychiatry and Neurology

Diplomate in Advanced Psychopharmacology

P (212) 647-9187

F (212) 243-1451

New York, NY 10011