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Home > Office Info > Forms

Forms

Registration Forms:

Family Registration Form
Medical History – Part 1
Medical History – Part 2
Privacy Policies
HIPAA Authorization
Financial Policy Agreement

Patient Forms:

HIPAA Medical Release Form
State of CT – Yellow Form
State of CT – Blue Form

Important Contact Numbers

Future Appointments:

Billing:

Medical Records:

203-229-2000 ext 2095

Portal Help or Tech Support

portalsupport@tcfap.com
203-229-2000

Breastfeeding Helpline

Patient Relations/Concerns

203-229-2000 Ext 2085

Human Resources:

203-229-2000 Ext 2012

We are in your Neighborhood!

Serving the communities of Norwalk, Wilton, Westport, New Canaan, Darien, Stamford and Greenwich.

Norwalk - 203.229.2000
40 Cross Street

Darien - 203.656.1833
85 Old Kings Hwy N.

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Register now for our April 2nd CPR Class!

Infant and Child CPR Class

Tuesday April 2nd

6 pm to 7:30 pm

Norwalk Office

Register now by emailing mstanton@tcfap.com