New Patient Screening Form

This is for all new patients looking to start care with our Primary Care practice. This New Patient Screening Form must be completed and submitted to our office for approval before an appointment can be made. To open the document, click on the text above. Submit via mail, fax, or dropping it off at the office.

Calls will be made after at least a week to notify you if you are accepted or not.

We are currently at least a month out for new patient appointments.

Limited amounts of new patients are currently being accepted.

New Patient Packet (After You Are Accepted)

For New Patients that have gone through the screening process and have made an appointment, please print out and fill in all of the information on all of the forms below. This must be brought to your first appointment, completely filled out. To open the document, click on the text above.

Insurances Accepted

Regular Blue Cross Blue Shield

Regular Independent Health

Regular Univera


Insurances Not Accepted

Straight NYS Medicaid