18 years and older

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Portal invitation request for 18 years and older (or teenagers who choose to manage their own accounts):
You will have your own portal account using your own private email. You may choose to allow other people to have access to this account. Please fill out the following information so we may send you an invitation to join the portal.

Patient Information:
First Name*
Last Name*
DOB
(mm/dd/yyyy)
*
Email*

You will receive an email invitation to join the portal within a short period of time.

 

Contact us at ThePediatricCenterofStamford@gmail.com with questions.