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Forms

To help make your life easier, we give you quick access to a variety of forms, all in one convenient location

For Patients:

Use this form to request medical records for yourself or to send to a provider/entity that is not listed as one of your providers in your intake paperwork.

This form is used to file a written grievance or incident report that occurred while at or with any staff of WNYBC. All patients and/or patient’s families may submit a written grievance and/or incident report without fear of reprisal. 

For Providers:

Use this form to request medical records for a patient of WNYBC.

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