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Practice Name

Samantha Slotnick OD, FAAO, FCOVD

Social Media
Primary Location
495 Central Park Ave, Ste 301
Scarsdale, NY 10583
Phone: 914-874-1177

Office Hours

DayOpenClosed
Monday10 am6 pm
Tuesday10 am6 pm
Wednesday10 am6 pm
ThursdayClosedClosed
Friday10 am6 pm
SaturdayBy Appt.By Appt
SundayClosedClosed
Main Content

At Samantha Slotnick OD, FAAO, FCOVD, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete some of the forms. Click here to download.

  • Download the required form(s). Print out the form(s) and complete the required information.

  • Fax your printed and completed form(s) to our office, and please bring originals with you to your appointment.


Online Forms:

New Patient Registration:
Adult    /     Child

Quality of Life Questionnaire

Vision Therapy Changes Checklist

Personal History, Adult


Printable Forms:

New Patient Health History Form, Basic, Adult

New Patient Extended History Form – Children

New Patient Extended History Form – Adult

Record Release

Educator's Checklist

Report Request

Adults with Strabismus Questionnaire

InfantSee Intake



HIPAA Privacy Policy

Download & Review Form



Download the Free AdobeReader®

Let's Meet!

Meet Dr. Slotnick and learn about signs of Vision Problems, FREE!

Call to reserve a space for yourself and a guest at our NEXT Workshop: 

914-874-1177

Leave your email and # below, and we'll be in touch with you soon!

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Extended Interview:
En "Vision" Your World

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Online Forms

Samantha Slotnick OD, FAAO, FCOVD offers our patient form(s) online so they can be completed in the convenience of your own home or office.
Download Online Forms Here

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Request Appointment

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

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Services

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

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Contact

Samantha Slotnick OD, FAAO, FCOVD
495 Central Park Ave, Ste 301
Scarsdale, NY 10583
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Administrative Office Hours

DayOpenClosed
Monday10 am6 pm
Tuesday10 am6 pm
Wednesday10 am6 pm
ThursdayClosedClosed
Friday10 am6 pm
SaturdayBy Appt.By Appt
SundayClosedClosed
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