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Golisano Children's Hospital – UR Medicine, Developmental and Behavioral Pediatrics fax number

(585) 742-4217

Intake - Developmental and Behavioral Pediatrics (Intake Coordinator)

Used for: Intake forms submission and related communications between families and the Developmental & Behavioral Pediatrics program

Fax destination details

Department
Intake - Developmental and Behavioral Pediatrics (Intake Coordinator)
Purpose
Intake forms submission and related communications between families and the Developmental & Behavioral Pediatrics program
Form
Intake form — Parent Questionnaire for New Patients
Address
601 Elmwood Avenue, Box 278877, Rochester, NY 14642
Voice phone
585-275-2986

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Complete the Parent Questionnaire for New Patients and fax it to Developmental & Behavioral Pediatrics intake at UR Medicine. Include any required documents (e.g., most recent school testing, current IEP/504 plan). For submission details see the official form and instructions: https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/childrens-hospital/developmental-disabilities/ndbp-site/documents/Parent-Questionnaire-for-New-Patients.pdf

Official form instructions are published as a downloadable file on the organization's website.

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