Contact Information
Family Planning Center
Corner of Main and Riley
1313 Main Street
Buffalo, NY 14209
- (716) 748-4988
- Mon, Tue, Wed, Fri
- 8:30am-4:30pm
- Thursday
- 8:30am-7:30pm
- Map & Directions
Family Planning Center
Forms
Last updated: 11/13/2008
These forms are for NEW patients only.
- Family Planning Consent Form
Instructions: Review, sign/date, and bring to appointment. - Consent for Treatment and Payment Agreement
Instructions: Review, sign/date, and bring to appointment. - Pre-Registration Patient Information
Instructions: Complete SECTION I, and bring to appointment. - Declaration of Income/Family Size
For uninsured patients without proof of income - Patient Self-Screening
Instructions: Complete and bring to appointment.
All forms are in PDF format unless otherwise indicated.