Patient Forms

Authorization Form to Transfer Medical Records - This form will accompany the confirmation email for those who register online via the patient portal,  or the form will be given to those who are accepted as new patients at their initial visit.

Financial Policy includes Credit Card on File Policy 

Privacy Policies

Contact Us

Please call us at (315) 991-4180 during our regular business hours.

Office Hours
Monday: 09:00 AM - 04:30 PM
Tuesday: 09:00 AM - 04:30 PM
Wednesday: 09:00 AM - 04:30 PM
Thursday: 09:00 AM - 04:30 PM
Friday: for emergencies only
Saturday: Closed
Sunday: Closed

Denise Wolken MD Pediatrics

                            Fax (315) 991-4046
6851 East Genesee St Fayetteville, NY 13066