If you are sick, experiencing fever, cough, shortness of breath or you believe you may have been exposed to COVID – 19. Please do not come to your scheduled appointment. Contact your Primary Care Physician immediately and then contact our office by phone: 716-250-9999 to schedule your appointment. PLEASE NOTE: We recommend that you NOT complete this form on the same day of your appointment. Due to delay in transmission of the file, we recommend that you arrive 30 minutes before your scheduled appointment to fill out the required paperwork at our office.

GO TO NEW PATIENT FORM