Skip to main content
menu

Referring Providers

Please use the form below to refer new patients. Just print, fill out, and fax to our office with all the medical records to: (585) 442-8039.

Please include any recent Pathology/Diagnostic X-Ray/Blood Work reports that you have ordered. Also please include recent progress notes, history and physical, and a copy of the patient’s insurance card.

If you have any questions please contact our new patient coordinator at: (585) 275-6775.

New Patient Intake Form