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Practice Name

Living Well Medical

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Primary Location
632 Broadway Ste 303
New York, NY 10012
Phone: 212-627-8149
Fax: 212-777-1653

Office Hours

Day
Monday10:00am7:00pm
Tuesday11:00am7:00pm
Wednesday10:00am7:00pm
Thursday11:00pm7:00pm
Friday8:00am1:00pm
SaturdayClosedClosed
SundayClosedClosed
Main Content

In order to provide you the best possible wellness care, please complete this form

Patient Data

Mailing Address

Current Complaints

Nature of Injury

Insurance Information

*If an auto accident, please provide:

Signatures

Name of the Insured _____________________________________________

I understand and agree that health/accident insurance policies are an arrangement between an insurance carrier and myself. I understand and agree that all services rendered to me and charged are my personal responsibility for timely payment. I understand that if I suspend or terminate my care/treatment, any fees for professional services rendered to me will be immediately due and payable.

Patient's signature _______________________________________________

Date ____________________

Spouse's or guardian's signature __________________________________

Date ____________________

Medical History

Have you ever:

Family History

Habits

Have you ever suffered from:

Need to get in touch with us? Call: 212-627-8149

By Subway: Take the BDFM to the Broadway/ Lafayette Station. OR the 6 Train to Bleecker St.

You can now quickly and easily book an appointment with us using ZocDoc.

New Patients

We accept most insurance plans. Please call or email to verify coverage.

All our procedures, methods, and techniques are non-surgical and non-invasive. Living Well Medical uses state-of-the-art, technologically advanced equipment to ensure long-term results for our clients.

Exclusive Offer

Supartz © knee pain injections can quickly and easily help you get back on your feet and live pain free.

Sign-up using the form or call us at 212-627-8149 to take advantage of this exclusive offer.

Name: *
Email: *
Phone: *

Patient Testimonial

They're funny, smart, and professional. I actually found his office through Google reviews when I had some back issues after my move to NYC, and am incredibly grateful I did. I can't recommend Dr. Sho and his team enough.

Request an Appointment

We will do our best to accommodate your busy schedule. Request an appointment today!

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Our Treatments

We strive to provide complete care for our patients. Learn more about all the treatments we provide.

Read More

Contact

Living Well Medical
632 Broadway Ste 303
New York, NY 10012
Get Directions
 
  • Phone: 212-627-8149
  • Fax: 212-777-1653
  • Email Us
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Office Hours

Day
Monday10:00am7:00pm
Tuesday11:00am7:00pm
Wednesday10:00am7:00pm
Thursday11:00pm7:00pm
Friday8:00am1:00pm
SaturdayClosedClosed
SundayClosedClosed
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