Forms

  1. Bayside Pediatrics Registration form *
  2. HIPPA form *
  3. Referral Request Form

WIC Program

  1. WIC (Woman, Infants, Children) Forms  – The New York State Department of Health’s Woman, Infants and Children Referral Form

Forms for school age children

  1. NYC School Health Form - Required for all new students (more information available at NYC.GOV.
  2. NYC School Medication Adminstration Form - Authorization for administration of medication for students (also available in 한글 Korean, Chinese and Spanish.)

*Please note:  If you are a new patient bring in the REGISTRATION and HIPPA forms to expedite your visit.