Patient Forms & Policies

Patient Forms

Downloadable Forms

Development Charts

Patient Policies


We provide extended evening hours for our patients during the school year, from November 1st through April 30th. Evening and weekend care is reserved for children who become acutely ill during the day, and who can not wait until the following day for care. One of our physicians is available through our answering service 24 hours a day, seven days a week for emergency calls.

Patients are seen by appointment only. A child who has a medical emergency will be seen on an immediate basis. If you need to have a second child in the family seen at the time of an appointment, please notify the secretary of this as soon as possible.

Billing and Insurance

View what insurances we accept and billing office information.

Surprise Medical Bills

Hospital and ER Visits

University of Rochester Medical Center (Strong Memorial Hospital) and Rochester General Hospital have dedicated pediatric emergency rooms. Should your child need urgent care or hospital-level care, please visit these facilities. Please call your doctor first for any non-life threatening emergencies prior to going to the emergency room. Many urgent matters such as stitches, injuries and illnesses can be taken care of at the office. Never use the emergency room for minor illnesses.

Labs and X-rays

Labs Tests

Onsite at Westside Pediatrics a basic lab is maintained where complete blood counts, hemoglobins, monospot tests, throat cultures, urine cultures, urinalysis, and other simple lab tests are performed. Any additional bloodwork required for a given circumstance can be done at the ACM lab located next door at 499 Beahan Rd, or you may be referred to additional lab sites.

X-Ray Exams

X-rays required Monday-Friday during regular business hours are done at Borg and Ide Radiology. The x-rays are read by the radiologist on site and the report is called/faxed to your physician who then designates the next step in care, as needed.  After hours, or on weekends, you may be referred to the emergency room or orthopedic care sites as directed by the physician for emergent situations.

Prescriptions & Referrals

Prescription Refill Information

If you are requesting a prescription refill, please have the name of the medication, the dose and amount of the medication needed, and the name and telephone number of your pharmacy. Refills for some medications may require a visit with the physician first, and you will be informed of this by the secretary.

Specialist Referral Information

If your child requires a referral to a specialist, please have the name and telephone of the specialist available when you call. If you are requesting a referral to a specialist for a condition which your pediatrician has not seen and/or treated, you may be asked to arrange an appointment with your pediatrician first.

Telephone Calls


Telephone calls are initially handled by our secretaries, who are experienced in determining from a description of a child’s symptoms whether the child needs to be seen, or whether the problem can be treated over the telephone. The secretaries can answer some questions regarding your child’s health. More complicated questions may be referred to a nurse who will return your call as soon as time permits. Emergency situations will be referred to a physician immediately.

Calling Your Pediatrician

If you wish to consult your physician by telephone, please leave a number where you can be reached during office hours, as well as later in the day. Your doctor is busy seeing patients during office hours, and often returns phone calls over the lunch hour or at the end of the business day.