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Child Patient Form
If you are a patient age 17 or younger, you are considered an child patient. You will need to be accompanied by your parent or legal guardian for your first visit. Please print and fill out this form to bring to your first visit. If you have any questions at all, please call us at 315-414-0224. We would be happy to answer any questions you have about the forms, our policies, or procedures.
If form does not display above, you can download form here.
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