Patient Forms

We are happy to provide our office forms for convenient download on your home computer. Please print and complete the appropriate form(s) and bring them with you to your child's appointment. Questions about which forms you need? Please call our office at 716-632-8050 and our courteous staff will assist you in preparing for your child's first visit.

Many of these forms are also available to be completed through your patient portal without the need to be printed.  For more information about our patient portal please Click Here

Online New Patient Forms

• New Patient Information Form
• Transfer Request To Amherst Pediatrics
• Patient Vaccine Policy

Transfer Request Forms

• Transfer Request To Amherst Pediatrics
• Transfer Request From Amherst Pediatrics

Well Visit Forms

• 9 Month Visit
• 18 Month Visit
• 24 Month Visit
• 18 & 24 Month Visits
• 4-11 Year Visits
• 12-21 Year Visits

ADHD Treatment Forms

• Parent Assessment Form
• Teacher Assessment Form
• School Release of Information

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.