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Patient Forms

Patient Forms

  • New Patient Registration Form
  • General Portal Information for Patients
  • Patient Privacy Notice
  • Financial Policy
  • Patient Medical History Form
  • Records Request Form

Dr. Fourtner & Dr. Danilovich

Email:
wnypedsendo@gmail.com

Phone:
(585) 201-7112

Fax:
(585) 201-7128

Batavia Location

  • Address
    5762 East Main Street Road Suite B
    Batavia, NY 14020

Williamsville Location

  • Address
    6631 Main Street
    Suite B
    Williamsville, NY 14221

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