1600 Stewart Ave. Suite 100, Westbury, NY 11590

(516) 243-8506


 

Orthopedic Surgery & Sports Medicine

George P. Ackerman, M.D.

Release of Information



If you would like us to release your medical information to another provider, medical entity, or individual, please complete this form and either fax it to our office it or bring it to your next appointment.


Fax: (516) 745-1189