Become a Patient

David J. Applebaum, MD, PA looks forward to having you join our host of satisfied patients. Dr. Applebaum's schedule is tailored for your convenience.  To schedule a consultation, please click here.

Once you have made your initial appointment, you can pre-register by clicking on the links for New Patient Forms below.  Our interactive forms are secure to protect your privacy.  Simply complete the information and submit.  As an alternative, you may download, print, and complete the forms prior to your arrival.  This well help to speed up the new patient registration process and get you in to see the doctor faster!

Interactive Forms:

• New Patient Registration Form
• Health History Form

Downloadable Forms:

• New Patient Registration Form
• Health History Form

Please note:  It may take a few minutes to load the forms if you are using a dial-up Internet Connection.  If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below. 

If you register online, all of your information is transmitted securely and is held in strictest confidence, adhering to HIPAA Guidelines and protecting your privacy.  You will need to print out a copy of the Privacy Policy, sign it, and bring it to your office visit.