Poison Control (800) 222-1222
Phone: (203) 481-7008

Fax: (203) 315-3779

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New Patients

We welcome new patients to our practice. Choosing a pediatrician is an important decision made by parents and for families relocating to the area. If you would like to get to know us better, we would be happy to schedule a courtesy visit at our office to meet a provider and tour our facilities. If you are having a baby and interested in joining our practice, please visit our “Having a Baby?” page.

It’s Easy to Become a New Patient in Our Practice!

Fill in the indicated paperwork below in order to establish your family at our practice. We cannot create a chart or book an appointment without all of it in place.

Once received, Heather, our Records Manager, will create the chart and have one of our receptionists call you, welcoming you to the practice and helping you make any needed appointments. IMPORTANT NOTE: A parent or legal guardian must accompany the patient on the first visit.

Several tips:

  • Make sure you have any needed forms (school, camp, sports, etc.) from your previous pediatrician! Make copies to use before your child’s first physical exam here, as we cannot fill out a form based on another provider’s evaluation.
  • Only parents or guardians can fill out and sign the forms below.
  • Make sure you have reviewed our Practice Policies and Vaccine Policy, ensuring we are a comfortable fit for you and your family.

Then….Follow the 2 Steps Below:

  1. Send a record release to your previous pediatrician to have the records sent to us. Our printable Record Release form can be used for this. If your child has a complicated medical history, these records should be included.
  2. Print, fill out, and sign these 4 forms. Mail, fax (203-315-3779), or drop them off. Indicate ATTN: HEATHER.
    1. Demographic Form
      Include all children’s names in the household.
    2. Authorized Representative Form
      Use a separate form for EACH child.
    3. Financial Policy Form
      IMPORTANT: include insurance information!
      See what insurances we participate with ›
    4. Vaccine Policy Statement

Once we receive all the documents, we will be calling you within the week. Welcome to our practice!