Southern Tier Pediatrics Southern Tier Pediatrics

Jamestown Office

1684 Foote Avenue Extension
Jamestown, NY 14701

Phone: (716) 661-9730
Fax: (716) 661-9732

Randolph Office

One Bank Street
Randolph, NY 14772

Phone: (716) 358-KIDS (5437)
Fax: (716) 358-5438

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Forms

  1. Patient-information-and-registration-10262007
  2. Patient-Information-Family-History-10262007
  3. New-York-State-Department-of-HealthEligibility-Screening-Record
  4. Release of Records Form 10262007
  5. HIPAA Privacy Information Patient Checklist 10262007
  6. NOTICE OF PRIVACY PRACTICES 10262007
  7. Office-Welcome-and-Information-Letter-10262007
  8. Financial Notice 10262007
  9. Patient Rights and Responsibilities 10262007

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