661 East Palisades Avenue. Suite A4

Englewood Cliffs, NJ 07632 US

646-343-9070

New Pediatric Patients

We are excited that you have chosen Asma Sadiq, MD for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.

Patient Portal & Forms

Please request an appointment on-line or call the office at (201) 408-477 or (646) 343-9070 for a appointment. On providing your e-mail address, You will be sent a personlized code to activate your personal patient portal.

Prior to your child's first visit, parents are requested to complete the New Patient Questionare plus scan and e-mail copies of previous evaluations and relevant reports to [email protected] or faxed to (201) 408-4661. Other consent and Hippa forms can be downloaded and completed as well.

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child.

Established patients are requested to complete the Medical update form prior to a follow-up visit and either scan / e-mail or bring additional relevant reports them with you to the appointment.

Please click here to access the portal: Portal Link

Patient Intake Form

Medical Release Form

HIPAA / Prescription Consent Form

Assignment of Benefits Form

Office Policy on Insurance and Payments

Lab Fee

Vanderbilt Parent Informant

Vanderbilt Teacher Informant

Vanderbilt Follow Up Parent

Vanderbilt Follow Up Teacher

Preschool Teacher Evaluation

School Age Report Form

Side Effect Rating Scale

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to expect

Directions :