Patient Forms

Below is a list of downloadable PDF forms. Feel free to fill out any of the forms before your appointment.


New York State mandates physical examinations for students entering the following grades:

  • Kindergarten
  • 2nd grade
  • 4th grade
  • 7th grade
  • 10th grade
  • first year of college

Sports, summer camps, and other activities usually require annual physicals. We will complete a physical form for you at the time of your child's annual physical exam and ask that you keep a copy for your future needs.

Exam room

A look at one of our exam rooms

Have a Question? Feel free to contact us.

Fairport Pediatrics, LLP
460 CrossKeys Office Park
Fairport, NY 14450-3590

Phone: (585) 223-6111
Fax: (585) 223-0878