PATIENT REGISTRATION FORM
Click here. Please complete it fully, sign & date at bottom, then fax, mail or bring to our office. Once we receive this we can create a new patient electronic medical record in our system. We also need records from your former pediatrician, and then we can schedule an appointment.
RECORD TRANSFER FORM
Here is a release form you can fill-out and give to your former pediatric practice. Click here. They may have their own form for you to use, but please advise we do not accept CDs or thumb drives. Our fax number is 860-674-9442.
RECORD TRANSFER OUT FORM
If you need to request medical records to transfer to another practice, please click here.
SCHOOL, CAMP AND SPORTS FORMS