Office Forms & Policies
All requests will be processed in 2-3 days. Please call the office at (212) 874-4500 if you are requesting a same day appointment.
You may download and print any of our forms listed below before coming to our office. This will get you out of the waiting room and in to see the doctor a lot quicker! You may either bring them with you to the first visit, or if you wish, fax them to us before your appointment.
You may download Adobe Reader for free at www.adobe.com.
Insurance Information
We participate with most local and many national insurance plans. However, it is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive.
If you provide complete and accurate information about your insurance, we will submit claims to your insurance carrier and receive payments for services. Depending on your insurance coverage, you may be responsible for co-payments, co-insurance, or other deductible amounts.
Form Policy
Our online patient portal offers a convenient way to submit your health forms. Please complete and upload your forms through the patient portal.
There is a $15 administrative fee for all camp and school forms to be completed within 7-10 business days.
A $35 administrative fee will be charged for all expedited forms. Expedited forms will be completed within 1-2 business days.
Completed forms may be downloaded from your child’s portal or picked up at the front desk. If you need a form mailed to you, please provide us with a self-addressed stamped envelope.
WESTSIDE PEDIATRICS ANNUAL PRACTICE FEE (APF)
May 2026-April 2027 APF
Greetings from your team at Westside Pediatrics!
As we celebrate our 30th(!) year, we remain committed to providing your children with the highest level of care. Westside Pediatrics continues to be an independent practice that accepts most insurance plans, and we are confident that our practice model remains the best way for us to provide outstanding, personalized, accessible care for your family. Our Annual Practice Fee (APF) is essential in maintaining this model.
The Annual Practice Fee (APF) will not increase in 2026 and continues to be capped for families of three or more. The May 2026 through April 2027 APF will remain $350 per patient, with a family maximum of $850. This is due in the month of May, applies to all patients, and will not automatically be charged to your credit card on file. Please click here to pay your APF.
For further information about our APF please click here.
If you feel this fee represents an undue burden, please contact our office administrator at APF@wppc.pcc.com.
We remain honored and thankful for our trusted relationships and the opportunity to care for your family.