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Long Island FQHC, Inc. is a nonprofit 501(c)(3) organization

(EIN/tax ID number: 27-0216316)

Long Island FQHC, Inc.  © 2010-2017.

All Rights Reserved. 1600 Stewart Avenue, Westbury NY 11590, Suite 300

Terms & Conditions |  Privacy Policy


This Health Center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

1.516.296.fqhc (1.516.296.3742)

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 New Patient Information & Forms  





What to Bring

When you arrive at Long Island Federally Qualified Health Center’s for the first time, we recommend that you bring the following:

If you have insurance:

If you don’t have insurance:


New Patients, please arrive 30 minutes before your appointment time.

Established Patients, please arrive 15 minutes before your appointment time.

Forms


For your convenience, you may complete new patient forms in advance. Please select and print from the options below, fill them out completely and bring them with you to your appointment.

New Patient Packet - Registration:  English  |  Spanish


Patient Rights & Responsibilities

The New York State Department of Health requires that patient’s seeking services be informed of their rights. It is part of your patient registration and is an important part of your health care plan.  

Adult - Patient Bill of Rights:     English  |  Spanish  |  Creole

Parent - Patient Bill of Rights:  English  |  Spanish  |  Creole


Privacy Notice

We are committed to maintaining the privacy of your protected health information. Our policies comply with the federal regulations under HIPAA (Health Insurance Portability & Accountability Act).

This Notice describes how your medical information may be used and disclosed and how you can access this information.

Privacy Notice - English | Spanish