Park Avenue Pediatrics
1111 Park Avenue
New York, NY 10128
ph: 212-534-3000
fax: 212-996-8420
Registration Forms
Please help us prepare for your first visit by downloading the attached four (4) forms.They are available in both Word document and pdf. format.
Please answer all questions and return the completed forms, together with a copy of the front and back of your insurance card to us.
You may return the forms to us by fax:
212-996-8420.
Att: Front Desk
or
You may mail the forms to us at:
Park Avenue Pediatrics
1111 Park Avenue
Completed forms can also be brought to the office at the time of your appointment. Please allow a little extra time for us to process your documents and, if necessary, to verify your insurance.
If you are transferring to our practice from another office, please do not forget to bring a copy of your child's medical record and immunization card with you or to forward the copies to us by fax or mail.
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1111 Park Avenue
New York, NY 10128
ph: 212-534-3000
fax: 212-996-8420
