Policies & Forms
Learn about the policies that help us provide you with the very best of care.
PortalBilling & InsuranceOffice Visits & AppointmentsAfter-Hours
CareImmunization PolicyTelemedicine Visits
Office Forms & Downloads
New Patient Forms
- Before your first visit, please complete our new patient forms. These may be reviewed and signed electronically through our digital check-in partner, Phreesia. We ask you to review these annually. Attached are our current practice forms for 2024.
- Financial & Administrative Policy 2024
- Notice of Privacy Practices
- Notice of Privacy Practices Supplement - CONNIE
- Privacy Practices Acknowledgement
- Assignment of BenefitsA standard form related to your insurance.
- Patient Communication Guidelines This is an important form added in 2022. Please review carefully so we can ensure the best communication between your family and our office staff and providers.
- Consent to Treat MinorAll caregivers who may be bringing your children to appointments must be listed on this form.
- Informed Consent for Telemedicine ServicesAll families who agree to a telemedicine visit are asked to review this form.
- Non Discrimination Policy
- Grievance Procedure
- Right to Receive a Good Faith Estimate of Expected Charges NoticeFor families who don’t have certain types of health care coverage or who are not using certain types of health care coverage
- Non-Covered Services Waiver 2024
Authorization Forms
- Authorization for Release of Medical InformationComplete this form to permit information to be shared between health care providers.
- Medical Records RequestIf you are moving away and you need your medical records released to you, please fill out this form.
Legal Resources
School & Camp Forms
Sound Beach Pediatrics continues to work to improve our workflow related to health forms. Your child will require these forms in order to attend daycare and school and participate in camp. We always work to provide your forms within 7 business days of your request.
You can send your requests for health forms via:
- Patient portal
- Email to [email protected]
- By mail or in person
The best time to have your health form completed is at the time of your child’s well visit, and these forms are generally accepted for 1 year from the date of your appointment. Vaccine records can be downloaded from our patient portal anytime, without a health form.
Our CT Health Assessment Records (for school age and early childhood) are now available digitally after your child’s well visit. Most camps and programs accept our general form and do not require additional paperwork.
If your child requires additional forms to be completed (asthma or food allergy related forms, college entrance health forms, sports clearance forms, NY State Health forms), these forms can be completed by hand and either mailed to you or scanned and posted to the patient portal.
School Forms
- Authorization for the Administration of MedicationRequired if medication is to be administered by school, child care, or camp personnel.
- Early Childhood Health Assessment Record
- Health Assessment Record
AthenaHealth Patient Portal
The AthenaHealth Patient Portal allows parents and patients (18 years and older) to communicate with your provider and staff about non-urgent matters, review visit summaries, request appointments, review lab and imaging results, download health forms and vaccine record, and much more.
FAQ
AthenaHealth provides answers to commonly asked questions about the patient portal.
Vaccine Records
To download vaccine records:
- Login to the patient portal.
- Click My Health on the left side.
- Click Medical History at the top.
Policies & Forms
To access SBP policies and forms, blank health forms, and digitally completed health forms (which can be provided after your child’s well visit):
- Login to the patient portal.
- Click My Health on the left side.
- Click Medical Forms at the top.
Uploading Files
To upload a PDF or photo to a patient portal message:
- Login to the patient portal.
- Click Home on the left side.
- Scroll down to the middle of the page to Messages.
- Click the downward arrow to Send a message and then Attach file.
Billing & Insurance
Sound Beach Pediatrics will bill the insurance you provide to us at the time of your service. We will need to verify your insurance information at every visit, to ensure that we have the most up-to-date information.
All copays are due at time of service and as part of the contract between you and your insurance carrier. Payments are preferred by credit card. We accept Health Savings Account (HSA) cards for payment. Checks are also accepted. We do not accept cash.
It is ultimately your responsibility to understand your insurance benefits. Our billing staff will be happy to assist you with questions. Download our complete Financial Policy.
Self-Pay Patients
You have the right to receive a Good Faith Estimate explaining how much your health care will cost.
Accepted Insurance Plans
- We participate in most insurance plans in order to make our practice accessible to all families in the community.
- Aetna
- Anthem Blue Cross/Blue Shield
- Cigna
- ConnectiCare
- Coventry First Health/ CHC National
- Harvard Pilgrim
- Healthy CT
- Medica
- Medicaid/HuskyAt this time we are closed to new Medicaid/Husky, and are accepting for existing patients moving from a private insurance plan, or new siblings of current Medicaid/Husky patients.
- MultiPlan/PHCS
- NGS Coresource
- Oxford Health Plans
- United Healthcare
Same Day Sick Visits
When your child is sick, we know you want quick answers to questions you may have. You should always feel comfortable calling us or communicating through our patient portal with questions. Please reach out if your child is exhibiting symptoms of illness or has minor injuries. A phone call is always recommended for any urgent medical matter. CALL 911 FOR ANY TRUE EMERGENCY.
We treat all general pediatric illness (fever, cough, rash, ear pain, sore throat, tummy pain, etc.). We also treat minor injuries – bumps and bruises, nursemaid’s elbow, minor lacerations – saving you a trip to the emergency room. We will always try to get your child evaluated on the same day that you call.
Preventive Care Visits
Services included in a typical well visit:
In-office well care is the pillar of pediatric health care! It is something we take very seriously and also enjoy. When your child comes in for a preventive or ‘well’ visit, we cover many important topics:
- Age-specific health concerns
- Growth and developmental assessments
- Routine and recommended screening tests (such as blood pressure, hearing, vision, depression screening, autism screening, maternal post-partum depression screening)
- Laboratory screening tests (hemoglobin, lead, cholesterol)
- Vaccine counseling and administration
- Anticipatory guidance specific to your child’s age and needs
The periodicity schedule provides comprehensive health guidelines for well-child care by age, and lists the screenings and assessments recommended at each well-child visit from infancy through adolescence.
Services not included in a typical well visit:
The following are considered separate services from the well visit:
- Evaluation and management of a significant new or existing health problem. (Examples include chronic abdominal pain, severe headaches, profound fatigue, poorly controlled asthma, a newly suspected food allergy, significant weight loss, an eating disorder, mental health problems).
- Discussions about ongoing complex health problems (Examples include seizure disorder, significant developmental delays, diabetes).
- Review of significant concerns related to a specific prior illness
- Coordination of care with specialists and ancillary health providers
- Addressing health concerns of siblings
If your child has a significant health issue raised during a well visit:
We will make every effort to accommodate and address non-preventative health concerns that arise during the well visit. But if the non-preventative concerns raised require more time than our schedule allows, we may need to schedule a follow up office or telemedicine visit. This is to help ensure that our office runs as smoothly and on time as possible and to avoid lengthy waits for families in our waiting rooms.
If we are able to accommodate both preventative and non-preventative health concerns during the same visit, we will need to bill for the visit accordingly, which may require a copay for the non-preventive component of the visit. Your insurance will process the visit codes according to your plan guidelines, applying copay, coinsurance, and/or deductibles as applicable. Health insurance contracts dictate our patient’s financial responsibility, and you will receive a bill for these additional services.
We are happy to answer any questions or concerns you may have about this.
After-Hours Care
If your child’s illness or injury is life-threatening, call 911.
Urgent Care
We know that children can get sick at any time! You can call our office 24 hours a day at (203) 363-0123. During office hours, you will be able to speak to a a member of our staff promptly. For urgent matters after hours that cannot wait until the next business day, your phone calls are handled by an automated answering service, Perfect Serve. Our clinical provider (a physician or nurse practitioner) will connect with you promptly and advise you on the best course of action.
Emergency Room Visits
If your child is taken to the emergency room, he or she will be evaluated and treated. The hospital will contact us regarding your visit, as well as inform you of the treatment plan including any follow up care needed.
Hospital Affiliations
We hold privileges at these local hospitals. However, in a true emergency, please call 911 or go to the nearest emergency room.
Greenwich Hospital
5 Perryridge Rd, Greenwich, CT 06830
(203) 863-3000
Stamford Hospital
30 Shelburne Rd, Stamford, CT 06902
(203) 276-7000
Vaccines save lives.
We believe in the effectiveness of vaccines to prevent serious illness and to save lives. Sound Beach Pediatrics requires that all of our patients are immunized according to the current vaccine schedule recommended by the Centers for Disease Control and the American Academy of Pediatrics. The vaccines (and the recommended schedule) are the result of many years of scientific study.
For details and recommendations about specific vaccines, see the Vaccine Information Statements published by the CDC.
Telemedicine Visits
Our telemedicine platform Doxy.me offers patients and their parents/care providers an exciting new means to connect with our health providers. Telemedicine visits will be done with live audio-video technology in a HIPPA-compliant fashion and documented within our AthenaHealth EHR, just like an office visit.
While not every health complaint will be suitable for a telemedicine visit, our providers will work as appropriate through this platform to review your health concerns, answer clinical questions, review medications, order laboratory testing, coordinate referrals and more.
Please note that telemedicine visits may be subject to co-pays and will be processed through your health insurance company just like an office visit.
Our Telemedicine Visit Workflow
Please call our office for an appointment at (203) 363-0123. You do not need a Doxy.me account. The visit can be done from any mobile device, your iPhone (or other mobile phone) or iPad. Providers may also contact you through the Doximity video-call platform, which is similar to FaceTime.
At the time of your appointment:
- You will receive a text from your provider with a direct link. Email is also an option.
- Make sure you are on WiFi with a strong signal in a private location.
- Your child must be present for most telemedicine visits.
- Click the link you received, and you will be brought into our virtual waiting room.
Telemedicine Links
- Informed Consent for Telemedicine ServicesDownload and fill out the telemedicine services consent form
- Getting Started with Doxy.meHow to check in for your telemedicine visit
Telemedicine Staff
- Katherine Noble, MDLicense: CT 041814
- Henry Rascoff, MDLicense: CT 042878
- Maggie Malloy Omstrom, MDLicense: CT 56257
- Meghan Warzoha, APRNLicense: CT 7290
- Liz Znamierowski, APRNLicense: CT 9184
Contact Us
Sound Beach Pediatrics
2001 W. Main Street, Suite 132
Stamford, CT 06902
Parking and entrance are located on Myano Lane, behind the office building.
Phone
(203) 363-0123
Fax
(475) 619-9855
Email
[email protected]
For general inquiries only, no patient health information
Office Hours
Monday Morning Walk-In Hours
7:45 am - 10:00 am
Wait times may vary based on demand.
Monday - Friday
7:45 am - 12:30 pm
1:30 pm - 5:00 pm
Saturday
9:00 am - 12:00 pm
All visits by appointment, except for Monday Morning Walk-In Hours.
Patient Portal
Please send messages related to non-urgent medical or administrative matters through our patient portal. We will respond within 2 business days (Monday through Friday).
For urgent matters, please call our office at (203) 363-0123. For a true emergency, please call 911.
After-hours Care
If your child’s illness or injury is life-threatening, call 911.
For urgent after-hours concerns, please call our office. Our clinical providers are on call 24/7.
POISON CONTROL HOTLINE
1 (800) 222-1222