Call Us: +1.585.924.2100
Victor Health Associates
6532 Anthony Drive
Suite A
Victor, New York 14564
+1.585.924.2100
Fax 1.585.398.1217
Complete this form in order for Victor Health Associates to receive medical information from another doctor or office you have seen.
Updated 6/2022
Important information on how we use or share your information, and your patient rights- in a condensed version.
Patient Forms
Important information on how we use or share your information, and your patient rights- the complete version.
New Pediatric Patient Information and Forms: For patients under the age of 18. Parent/Guardian only must review and complete the necessary forms. Return a to the office no later than the date of first visit.
Updated 8/2023
Please make sure that all patient portions of any form are completed prior to returning or submitting to the office.
Health Care Proxy with form instructions.
The Physical Health History Form is to be completed by all adult patients prior to their scheduled Physical Exam.
**Please visit our Physical Appointments Page for additional information and lab order instructions
Updated 7/2023
Complete this form if you are requesting Victor Health Associates to send your medical information to another doctor/office/or party.
To be completed by parent/guardian for patients under the age of 18. Consent for treatment of minor patient in absence of parent(s) or legal guardian.
Updated 9/2019
Adult New Patients & Pediatric Patients transition to Adult Care: Please print and review the information and complete forms. For those new to the Practice, return the Medical Records Release as soon as possible, bring all other completed forms with you to your appointment. Please arrive early to complete any needed forms if not done in advance.
Updated 8/2023
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