Admitting Forms

All forms must be submitted to the New York Eye and Ear Infirmary of Mount Sinai (NYEE) Admitting Office at least four business days prior to your patient's scheduled admission date. Please fax forms to 866-333-0174.

Please read the following instructions carefully and complete all necessary steps.

1. Prior to scheduling, please review the following information:

2. Consult the Adult and Pediatric sections below to find all patient-specific forms that must be completed and submitted at least four business days prior to your patient’s scheduled admission date. Please include the CPT/ICD 10 code associated with all diagnoses. Fax all forms to 866-333-0174.

3. Please review these special instructions for the required Pre-Admission Registration Form:

  • All areas pertaining to the physician’s specific surgical procedure must be completed.
  • Please include all insurance information, including precertification form and/or authorization for NYEE services to be provided.