Patient Form

Patient Forms

Documents for providing your medical history, personal information, and consent to ensure accurate and efficient care.

Demographic & Insurance Information Form

HIPAA Privacy Acknowledgment Form

Financial Policy - Payment Responsibility Agreement

New-Patient Forms

Consent for Treatment

We’re Here When You Need Us

Walk-in care and support for all your health needs, from routine checkups to urgent care. Our team provides safe, reliable, and compassionate care whenever you need us.

North City Medical provides accessible, high-quality care for the Brooklyn community in one convenient location, offering preventative, chronic, and urgent care delivered with compassion and cultural sensitivity.

Quick Links

Appointments

We will do our best to accommodate your busy schedule.

Contact

Call On Phone:

+347-844-2543

Fax Us:

+347-378-8011

Send A Message:

info@Northcitymed.com

North City Medical 2025 Developed By - MedGro Digital

1022 Nostrand Ave

347-844-2543