Health Form Policies

Turnaround time for completion of forms is 7 business days. You may pick up the completed form in our office during our normal business hours. For security reasons, we do not fax forms.

Our office observes American Academy of Pediatrics and New York State guidelines for screenings. Please be aware that your insurance may not cover this service, and while you may have a “zero co-pay” for well visits, this may not apply to all parts of the visit.

Medication Refills

Medication refills are managed Monday through Friday, from 8:00 am – 5:00 pm. Refills requested after 3:00pm will be handled on the next business day. Prescriptions for controlled substances require a 72 hour notification and must be picked up at our office with identification.

Physical/Health Assessment Form

It is our policy that in order to complete a form for a patient 3 years of age or older, the patient must have had a physical examination within the past 12 months. If your child is overdue, an appointment may be scheduled, at which time the form will be completed.

We provide at no charge a generic physical form for each yearly physical. This form is accepted by schools, camps, and other organizations. Please make a copy of this form for future use. If you require a reproduction of this form, or request that we fill out a form that you provide to us, there will be a fee of $10 that must be paid prior to processing your form request.

Daycare Forms

For children in daycare, we will complete a NYS Dept. of Social Services adapted daycare form based on the most recent physical. If you already have received a daycare form, but your child has since received additional immunizations, we will provide a print out of your child’s immunization record only, at no charge.

Medconsent Forms

Medications are best given at home by the parent. In cases where medications must be given during school hours, we will provide a medication consent form. Please call our office to request a medconsent form.