Please fill out the note request form listed below. Please be aware that public schools do not require the $5 NYS Form. To avoid delays, please be sure to request the correct form. As our office does not know which form you need, please check with daycare, afterschool program, camps directly.
**Due to the high volume of requests our office receives, completion of this request may take up to 10 business days to be completed.
Please be aware:
*The request must be filled out in its entirety, we will not contact you to obtain additional information.
*All requests MUST be submitted by the patient's Parent or Guardian.
*We do not email completed forms.
***There will be a $5 fee for the NYS-Office of Children & Family Services Individual Allergy & Anaphylaxis Emergency Plan 3-page document that must be paid prior to the note being completed.
PLEASE NOTE IF YOU HAVE NOT BEEN SEEN FOR A FOLLOWUP IN THE PAST 12 MONTHS, A NOTE WILL NOT BE PROVIDED. PLEASE CONTACT THE OFFICE TO SETUP AN APPOINTMENT (315)701-9500.
Please understand that these notes can be time consuming to complete. Our office will fill out the first note as a courtesy (beside the NYS form mentioned above). If a request is made for the same note, there will be a $5 fee to be paid prior to the note being redone.
Thank you.