Online Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the complete and send button at the bottom to electronically send us your information.  The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Please call Cohen Surgical Arts Phone Number 973-627-6006 with any questions or use our on-line Contact Us form to schedule an appointment.

Technical Note:

PC Users

Our online form uses Adobe Acrobat Reader 5 or greater plug-in to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 5 of the plug-in to successfully use our online form.

Mac Users

You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.