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At Samantha Slotnick OD, FAAO, FCOVD, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • Please download, print and fill out all needed forms (AdobeReader® required).
  • Please contact Jane, our Patient Care Coordinator, to determine which forms you will need. [email protected]. 845-519-3521.
  • You can return forms via fax (914-885-1463) or scan/email to [email protected].
  • Remember to bring originals with you to the first appointment.


Printable Forms:

New Patient Health History Form, Basic, Adult

New Patient Extended History Form – Children

New Patient Extended History Form – Adult

Record Release

Quality of Life Questionnaire

Educator's Checklist

Report Request

Adults with Strabismus Questionnaire

Brain Injury Visual Symptom Survey

InfantSee Intake

Directions via Public Transportation / train schedule / bus 20/21 schedule



HIPAA Privacy Policy

Download & Review Form

Location

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Administrative Office Hours

Exams By Appointment Only

Monday:

10:00 am-6:00 pm

Tuesday:

10:00 am-6:00 pm

Wednesday:

10:00 am-6:00 pm

Thursday:

Closed

Friday:

10:00 am-6:00 pm

Saturday:

By Appointment

Sunday:

Closed

Testimonials

Reviews From Our Satisfied Patients

  • "Dr Slotnick is a great optometrist. I brought my three year old to her and had my own exam. She connected with my son wonderfully and was very attentive to us both. Caring doctor with a great sense of humor. Thank you!"
    Lenny K.
  • "Dr. Slotnick always goes the extra mile when evaluating my eyes. Her knowledge, care, and skill set over the years have been impeccable!"
    Jeff Pinto, primary care patient for 7 years
  • "Dr. Slotnick is one of the brightest behavioral optometrists in the nation. She has a wealth of knowledge and caring and will do an excellent job for your child."
    Dr. David Cook
  • "Bright person, great optometrist, always has a smile on her face."
    Dr. Josef Thiel