Name * First Name Last Name Email * The issues I am hoping to address with Dr. Simone are: * Best time of day to reach me: * Phone number for consultation call: * (###) ### #### I understand that Dr. Simone requires payment at the time of service and does not work directly with insurance companies. I will receive a superbill to submit for reimbursement to my insurance company. * I understand that a phone consultation is offered to help determine whether Dr. Simone and I would be a good fit for working together and does not constitute the establishment of a doctor patient relationship. * Thank you! To schedule a free 15 minute phone consultation, call (607) 261-7784 or fill out the form below: Connect with Dr. Simone: