Online Consultations
To submit patient forms via the website, please follow these steps:
1. Download the forms to your comptuer
2. Fill out forms and save the completed form to your computer
3. Then on the website, fill out the info in the submit a form section and be sure to attach the completed version of the form/s before submitting
- Patient Information Form
- Notice of Privacy Practice
- Office Visit Waiver
- Photo Authorization
- Credit Card on File
Download Adobe Acrobat Reader to view, download, and complete each form.
Office Phone: 203-861-6620
Office Fax: 203-861-6621
Office Hours
| Monday | 8:30am – 4:30pm |
| Tuesday | 8:30am – 4:30pm |
| Wednesday | 8:30am – 4:30pm |
| Thursday | 8:30am – 4:30pm |
| Friday | 8:30am – 4:30pm |
Elsa Raskin MD
Greenwich Office
4 Dearfield Dr. Ste. 102
Greenwich, CT 06831