Town & Country Pediatrics and Family Medicine, PC

Town & Country Pediatrics and Family Medicine, PC

Dr. Ephraim P. Bartfeld | Dr. Jacqueline O. Lustig

380 Main St. Watertown, CT 06795   (860) 274-8891
205 Columbia Boulevard, Waterbury CT 06710

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  • Home
  • About Us
  • Our Staff
  • Patients
    • Resources for Children
    • Resources for Adults
    • Patient Forms & Documents
  • Hours & Directions
  • Patient-Centered Medical Home
  • Patient Testimonials

Patient Forms

  • New Patient Forms
  • Consent To Treat Minor Patient With An Adult Other Than Parent or Legal Guardian OR Consent To Treat A Minor Patient Without An Accompanying Adult (Age 16 or Older)
  • Patient Authorizaton To Disclose Personal Health Information
  • Notice of Privacy Practices
  • School Form: for children birth – 5 years of age
  • School Form: for children 6 years and older

Sick Child?

View the KidsDoc Symptom Checker from HealthyChildren.org

Patient Resources

Browse our online resource center of patient handouts and more!

Patient Portal

Town & Country Pediatrics and Family Medicine, PC
380 Main St. Watertown, CT 06795
205 Columbia Boulevard, Waterbury CT 06710
(860) 274-8891

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