Medical forms, your visit and appointments
Provided below are various forms that may be required prior to your visit. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe icon. This will allow you to download this software, providing access to the forms. Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process. Thank you.
Planning Your Visit
When you arrive for your visit, please be ready to present your current insurance card and co-pay (due at time of service). Please bring all of your current medications with you. If you bring a list, be sure it's up-to-date and includes medication names and dosages.
If you need to cancel an appointment, kindly provide 24-hours notice by calling the office. Please understand that you may be charged a cancellation fee if you do not provide 24-hours notice.
Contact Info
Telephone: 203-244-9529
Fax: 203-648-4172
eMail: PBK Primary Care
PBK Primary Care
DANBURY
Tuesdays and Fridays 8am - 5pm
27 Hospital Avenue
4th Floor Suite 404
Danbury CT 06810
MIDDLEBURY
Wednesday 8am - 5pm
850 Straits Turnpike Suite 1
Middlebury CT 06762
Patient Forms
You can download, print and fill-out the forms ahead of time.
If you cannot access the forms on your device – click on the icon below to download the PDF software.