Became A New Patient

Dear New Patient,

Download the Patient form

Thank you for inviting us to join your team on your journey toward improving your health.

Before your first visit:

1) Call our office to schedule your initial consultation at (516) 676-0200 between the hours of 9am and 5pm Monday through Friday.

2) Please follow the link to our new patient intake form. Fill out the forms as completely as you can. This will help us ensure maximum efficiency during your visit. If you are unable to download these forms prior to your visit, please arrive thirty minutes earlier to your scheduled appointment so you may complete them at that time.

3) Please download the Diet Diary and the instructions. Please make six copies of the Diet Diary page and fill out for as many days as you can (up to four days and two weekend days). Please do not change your eating habits or lifestyle during this time so we can get an accurate assessment of your nutrient intake.

4) Please gather all laboratory reports, diagnostic imaging reports, etc. that you have available. If you do not have copies of these already, I suggest making two copies, one for the clinic to keep in your chart, and one for your own records. You can also have these emailed to our office at: If applicable, please bring latest X-Rays, CAT scan or MRI films.

5) Bring in all supplements and medications you are taking to your first visit so we can review them together. Do not change or alter dosages of any prescription medications with out speaking with your prescribing physician.

We look forward to meeting and working with you. Feel free to contact our clinic with any questions or concerns at 516-676-0200.

Kristine Blanche PA-C, PhD


Northport Wellness Center
220 Fort Salonga Rd
Northport, NY 11768


Please note a non-emergency cancellation less than 24 hours in advance of your appointment will incur a charge $200 fee for new patients, $100 for follow up visit.

Please fill out the form below to schedule your appointment today!

Contact Us

Northport Wellness Center
220 Fort Salonga Rd. (25A)
NY 11768
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