Your Visit

Welcome to Ruttenberg Treatment Center! We want to help you move through your cancer journey knowledgeably, comfortably, and efficiently. With this in mind, we have compiled here practical information that will help you prepare for your first visit to Ruttenberg.

When you call to make your first appointment, please have the following information handy:

  • Patient’s full name
  • Patient’s date of birth
  • Best phone number to reach patient
  • Patient’s permanent address
  • Diagnosis, if known
  • Name and telephone number of insurance provider
  • Name of insured party


After you’ve made your appointment, please fill out the essential forms and information.

  • Hematology Oncology Personal History Form: It is very important to complete this form carefully, as it will serve as the basis of your first consultation with your Ruttenberg physician. Sometimes it is helpful to fill this form out with a family member or close friend who may be able to help you recall some of the details of your health history. 
  • Authorizations and Assignments: By signing this form, you are acknowledging your responsibility for charges billed by Mount Sinai Hospital and Icahn School of Medicine; giving your consent to the Hospital, the School of Medicine, and your physician to disclose health information to your insurers and others if needed to obtain payment; and authorizing payment of your medical benefits to be made directly to your service providers. 
  • Use of Information Authorization: This form requests your permission for your doctors to disclose your name and contact information to Mount Sinai’s Development Office for the purpose of contacting you with marketing information and/or about fundraising efforts that support the work of your doctors.
  • Agreement to Receive Messages Containing PHI at Home: By signing this form, you are authorizing the physician you name on the form (or his/her designee) to leave messages containing Personal Health Information on your home answering machine, with someone other than yourself who answers your home telephone, or at another telephone number specified by you.