Glastonbury New Patient Intake Forms (Please fill out all 6 forms before your first appointment)
- CLICK HERE
Patient Registration
- CLICK HERE
Patient Health Questionnaire
- CLICK HERE
Notice of HIPAA Privacy Practices
- CLICK HERE
Authorized Contact Medical Release Form
- CLICK HERE
Release for Medical Records (Entering CCC - Glastonbury)
- CLICK HERE
Review of Systems - Glastonbury
Request an Appointment
- CLICK HERE
Request an Appointment in Glastonbury
We accept additional insurance plans not listed here. If you do not see your carrier listed here, give us a call to confirm that your insurance will be accepted,
(860) 657-0764.
Appointment Cancellation Policy
You must call 24 hours prior to your scheduled appointment time to avoid a mandatory $25 cancellation fee.
Additional Information
- CLICK HERE
Patient Rights
- CLICK HERE
Patient Complaint Form
- CLICK HERE
Release for Medical Records (Leaving CCC - Glastonbury)
- CLICK HERE
Medicare Wellness Health Risk Assessment
Only for patients on Medicare