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STAMFORD OFFICE
203.323.1770
NEW CANAAN OFFICE
203.972.5232

POLICIES

SPECIAL NEEDS
If you or your child have any special needs, we will do our best to accommodate them. Please notify our nursing staff.

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ACCOMPANYING YOUR CHILD We understand that you may not always be available to bring your child to a scheduled appointment. If you expect that another individual will accompany and be responsible for your child at any time, please complete our Consent for Treatment Form. Patients 16 years of age and older may come to appointments unaccompanied, however we will need parental permission by phone in order to administer any vaccinations.

New England Pediatrics may request identification of the person who accompanies your child to confirm they are indeed the individual listed on the Consent for Treatment form.

PRIVACY POLICY (HIPPA) New England Pediatrics understands that your health information is personal and private. As a patient of New England Pediatrics, you will be asked to read our Notice of Privacy Practices and to sign our Acknowledgement of Receipt of Notice of Privacy Practices.

Our Notice of Privacy Practices (HIPPA) describes our legal duty to protect your child's health information, how medical information about you may be used and disclosed and how you can obtain access to this information.

Any questions regarding our privacy practices may be directed to our practice manager at 203.972.5232 x218.

MEDICAL RECORDSTo obtain a copy of your medical records:
  • Please fill out and sign the Patient Directed Release of Records. For transfer to another practice, tell us if you want office notes only or all consult letters, lab and X-ray results. Per Connecticut law, the charge is 65¢ per page for copies plus the postage fee if the records are to be mailed. If you prefer an electronic copy and it is available for your records there is a flat $25.00 charge plus postage if applicable.
  • Be sure to identify to whom the records are being released, the purpose for the disclosure and allow 10 business days to process your request.
  • Patients 18 years of age or older must request and sign for their records or give us written permission for release to a parent or other individual.
  • If you plan to return to New England Pediatrics after a finite period, we will keep your chart on file. Otherwise, transferred records are placed in storage one year after transfer and retained for seven years after the last visit.

 

POLICIES

SPECIAL NEEDS
If you or your child have any special needs, we will do our best to accommodate them. Please notify our nursing staff.
ACCOMPANYING YOUR CHILD We understand that you may not always be available to bring your child to a scheduled appointment. If you expect that another individual will accompany and be responsible for your child at any time, please complete our Consent for Treatment Form. Patients 16 years of age and older may come to appointments unaccompanied, however we will need parental permission by phone in order to administer any vaccinations.

New England Pediatrics may request identification of the person who accompanies your child to confirm they are indeed the individual listed on the Consent for Treatment form.

PRIVACY POLICY (HIPPA) New England Pediatrics understands that your health information is personal and private. As a patient of New England Pediatrics, you will be asked to read our Notice of Privacy Practices and to sign our Acknowledgement of Receipt of Notice of Privacy Practices.

Our Notice of Privacy Practices (HIPPA) describes our legal duty to protect your child's health information, how medical information about you may be used and disclosed and how you can obtain access to this information.

Any questions regarding our privacy practices may be directed to our practice manager at 203.972.5232 x218.

MEDICAL RECORDSTo obtain a copy of your medical records:
  • Please fill out and sign the Patient Directed Release of Records. For transfer to another practice, tell us if you want office notes only or all consult letters, lab and X-ray results. Per Connecticut law, the charge is 65¢ per page for copies plus the postage fee if the records are to be mailed. If you prefer an electronic copy and it is available for your records there is a flat $25.00 charge plus postage if applicable.
  • Be sure to identify to whom the records are being released, the purpose for the disclosure and allow 10 business days to process your request.
  • Patients 18 years of age or older must request and sign for their records or give us written permission for release to a parent or other individual.
  • If you plan to return to New England Pediatrics after a finite period, we will keep your chart on file. Otherwise, transferred records are placed in storage one year after transfer and retained for seven years after the last visit.

 

“We've had bad luck with our
kids - they've all grown up.”
— Christopher Morley

STAY INFORMED

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