Forms

Medication Authorization Request Form (Please note this form needs to be filled out completely by the patient, or family, for Wildwood Pediatrics to begin to process the request.)                                                                                                       

 

Record Release Form

 

Privacy Policy

 

Patient Satisfaction Survey

 

Essex Office One Wildwood Medical Center
35 Saybrook Road
Essex, CT 06426
Tel: 860.767.0168

Hours:
8:30 am to 5:00 pm M-F
8:30 am to noon Saturday


Ped-I-Care After Hours Care
Available in Our Essex
Office

Hours:
6:00 pm to 8:00 pm M-F
Noon to 5:00 pm Saturday
11:00 am to 4:00 pm Sunday & Holidays

Old Saybrook Office 30 Elm Street
Old Saybrook, CT 06475
Tel: 860.388.4545

Hours:
8:30 am to 5:00 pm M-F

NCQA Recognized