On-line Appointment Request

By agreeing to the terms of our Online Appointment Request form, you will enter a secure area of our site. The Children’s Medical Group will be held harmless should your electronic message not be transmitted due to technical problems related to this site or hosting server. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties.

We will respond to your request within 24 hours, Monday – Friday, 8:30 am – 5:00 pm. If you do not hear from us within that timeframe or should have any questions regarding your appointment request or this on-line form, please contact us by phone at (845) 452-1700.

If you do not accept the terms of this site disclaimer, you will not be able to process your appointment request on-line.

Please Note: At this time, this on-line form is only for Well Check-ups, Consults and Interviews.