Medical Records & Prescription Requests
Medical Records Requests
Any request for copies of Medical Record will be subject to the following terms:
- A Request for Records form must be completed and signed by the legal guardian/parent of the patient
- Patients age 18 and above themselves are legally responsible for completion of forms and the terms associated with the Request for Records.
- A $25 fee will be charged for completion of all other forms: medical leave of absence, disability, repeated requests for forms.
Please call Pediatric Medical Associates New Haven today or fill out the form below once the request form has been completed.
Prescription Requests & Information
Prescriptions are now sent automatically to the pharmacy of your choice. Please call your pharmacy to request a refill. If you believe your child is in need of a new prescription or a refill please call Pediatric Medical Associates today or fill out the form below. Always use the dispenser that comes with the product. Never a kitchen teaspoon. If possible, use weight to dose; otherwise use age.