8203 Main Street, Suite # 7
Williamsville, NY 14221
Tel: 716-565-1830
Fax: 716-565-1836

   

Online Registration

In order to use our Online Registration Portal, please read these instructions carefully:

You have two options on how to complete them and submit them to our office. To use either option must have an up to date PDF reader installed on your computer. We recommend Adobe Reader.

 

•Click on the link below marked Online Registration Package. Our form will open up as a PDF file.
•Fill out the form on your computer and then save it to your computer.
•You can then either print it and bring it with you or you can submit it securely through our online submission portal below. Our preference is that you send it in advance of your appointment, so we are better prepared to serve you upon your arrival.
•If printing them out, you are done. If submitting them to us, please continue reading.
•Once you have completed and saved the form to your computer, come back to this page and complete the submission form below.
•You will need to enter your name, your email address, attach your registration package and you may leave a comment before submitting it to us.
•Troubleshooting: If you are having trouble with the print or save button on the form, go to the Adobe top menu bar and click on the print or save icons. If those icons are not being displayed then go to the browser’s top menu bar and click on File. On the drop down menu click on either Save as… or Print. We recommend saving the file first before printing. If you continue to have any issues, please contact our office.

 

New Patient Information Package