The New York Hospital- Weill Medical College of Cornell University 2026

1. Click ‘Get Form’ to open the New Patient Intake Form in our editor.
2. Begin by entering your full name, preferred name, and pronouns in the designated fields. This information helps personalize your care.
3. Fill in your date of birth and the name of the person who referred you. Clearly state the reason for your visit to ensure appropriate care.
4. Complete the Sexuality/Gender Identity section by selecting your sexual orientation and assigned sex at birth. Provide details about your gender identity as well.
5. In the Recent Exam section, indicate the date and type of your last exam, along with its location.
6. Proceed to Gynecologic History, where you will provide details about your menstrual cycle and any relevant medical history.
7. List current medications, allergies, and any past medical or surgical history in their respective sections.
8. Finally, complete the Family History and Social History sections to give a comprehensive view of your health background.

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