Patient Registration

Save time before your first visit and make an appointment online as an ITHC patient.
To make an appointment, just complete and submit the form below.

All information provided will remain strictly confidential and will not be
distributed by ITHC in any form unless requested by patient named below....

To contact ITHC's Medical Director, Rajiv Narula, M.D., e-mail ithc@globaltraveler.com

*Your Name:

*Your Email:

Possible Date & Time Of Appointment:


Office Location for Visit:
Please Select: New York City Poughkeepsie

Date Of Birth:

Employer:

TelePhone #:

Cell Phone #:


Date of Travel(if any):

Payment Type:
Please Select: Cash Credit Card

Reason for Visit:

Where did you hear about us.:

Comments Concern


Please Enter this Security Code


    

Office Hours:

Mondays :10am - 2pm

Tuesday :12am - 4pm

Wednesdays: 10am -5pm

Thursdays: 9am -1pm

Fridays:10am - 6pm

            Same day appointment is available upon request