Form Downloads


  1. Registration form for patients Newborn to 17 years of age
  2. Release of Protected Health Information From GF Pediatrics or Pediatric Asssociates of Saratoga
  3. Release of Protected Health Information To GF Pediatrics or Pediatric Asssociates of Saratoga
  4. New Born Package
  5. New Patient Package
  6. Authorization for Treatment of Minor When Parent is Not Present
  7. Authorization for Immunizations of Minor When Parent is Not Present
  8. Permission to Administer Medication in School
  9. Vanderbilt Assessment Scale
  10. MCHAT - Autism Screen 
  11. HIPAA Consent Form 
  12. HIPPA Consent Form for a patient at least 18 Years of Age
  13. Patient registration form for a patient at least 18 years of age

All forms are in PDF PDF format. Click Here to download Adobe Acrobat.


Glens Falls Pediatric Consultants, P.C.

Glens Falls Pediatrics1 Lawrence Street
Glens Falls, NY 12801
Phone: 518-798-9985
Fax: 518-761-7043

Pediatric Associates of Saratoga

Saratoga Pediatrics4 Carpenter Lane
Saratoga Springs, NY 12866
Phone: 518-587-3823
Fax: 518-587-6677


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