TEL (718) 712-8511
FAX (718) 527-5624

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    Documents and Forms

    Quick easy access to all the forms. To fax documents to our office, please dial (718) 527-5624.


    Covid Vaccination Consent Form 5 to 11 y/o 


    Pre-vaccination checklist 5 to 11 y/o


    Covid Vaccination Consent Form 12 and older

     
    Pre-vaccination checklist 12 and older
     
    Camkids Demographic Form

    Camkids Healthix Form

    Camkids Financial Policy

    Camkids HIPAA Form

    Camkids Notice Of Privacy Practices 

    Camkids Consent for 18+ and Emancipated Minors 

    Vanderbilt Parent Informant Initial

    Vanderbilt Followup Parent Informant

    Vanderbilt Teacher Informant

    Asthma Control Test Under 4 years old

    Asthma Control Test 4 - 11 years old

    Asthma control Test 12 and Older
    For Life-Threatening Emergencies Call 911

    New?

    Download registration form

    Book an Appointment

    Monday - Thursday
    8:30am – 7:00pm
    Friday
    8:30am – 6:00pm
    Saturday
    9:00am - 3:00pm
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    (718) 712-8511
    After hours


    A doctor or nurse is available to speak with you weekdays after 7pm. 

     

    Please call us at

    (718) 712-8511 with your questions.

    117-06 225 Street 
    Cambria Heights, NY 11411
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