Appointment Request Form

Request Appointment at Dr. Stephen Lazarou
Contact Information
Personal Information

The practice accepts most insurance and HMOs, including Medicare, as well as Visa, MasterCard and American Express.

Parent/Guardian Information

All fields marked * are required.

Communications with our office via this website are not intended to replace an office visit. Please do not include any personal health information when completing this form. This form should be used only for routine and non-urgent matters. If you are experiencing a medical emergency, please call 911 or go to your nearest hospital emergency room.