Forms
There are many daycare, school, and camp forms that will need to be completed throughout each year. Due to rising administrative costs, you will be charged a one time $10 fee per child per year to prepare any forms that are needed. This fee is payable prior to the release of the requested forms.
We do offer a generic New York State form that can be used for school or camp. There is no charge for this form, and it may be attached to the prescribed forms sent by your school or camp. Please feel free to make additional copies of the forms we provide at the time of your child’s check up.
Patient Information Sheet
Patient History Form
Financial Agreement
Insurance Information
Medical Record Transfer
Medical Record Release
Permission to Administer Medical Care
Privacy Policy HIPAA