Patient Paperwork

Click on links to open PDFs in a new tab to download and print necessary paperwork.

 

New Patient Registration Packet

New patients should complete these forms and bring them to their first visit.
PT REGISTRATION AND HISTORY FORM

 

Risk Assessment for Familial Breast Cancer

If requested by the provider, patients should complete this form and bring to their visit.
RISK ASSESSMENT FORM

 

Authorization to Disclose Medical Records

For patients who would like Saratoga Hospital to disclose their medical records,
please complete this form and fax to 518.581.0141
or scanned and emailed to dbellerose@saratogahospital.org
DISCLOSE MEDICAL RECORDS FORM

Please allow up to 7 to 10 business days for the request to be processed

 

Authorization to Release Medical Records

For patients who would like Saratoga Hospital to receive their medical records,
please complete this form and fax to 518.581.0141
or scanned and emailed to dbellerose@saratogahospital.org
RELEASE MEDICAL RECORDS FORM

Please allow up to 7 to 10 business days for the request to be processed

 

HOURS

Monday through Friday
8:30 am – 4:30 pm

PHONE

518-587-2400
Fax: 518-581-0141

MAP
Go to Top