The Medical Society of the State of New York is assisting governmental health agencies in the development of a database of physician information to be used only in the event of a bio-terror or natural disaster. Your cooperation in completing the following survey would be greatly appreciated.

Please print clearly and fax completed survey to: 516-326-9708
or mail to:

MSSNY
420 Lakeville Road,
Lake Success, NY 11042

Back to Home Page