English Road Pediatrics & Adolescent Medicine

Transferring In & Out of Our Practice

To become a patient at our practice;

1. Print the transfer form
2. Complete the form
3. Send a copy to both your current pediatrician's office and to us.

You may either fax the completed form to (585) 225-2626 or mail it to;

Medical Records
English Road Pediatrics & Adolescent Medicine
1800 English Road, Suite 10
Rochester, NY 14616

To transfer your child's medical records to another office;

1. Print the transfer form
2. Complete the form
3. Fax it to our office at (585) 225-2626 or mail it to us at the above address.