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