Waiting Room Primary Care Danbury CT

Medical forms, your visit and appointments


Provided below are various forms that may be required prior to your visit. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe icon. This will allow you to download this software, providing access to the forms. Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process. Thank you.

Planning Your Visit


When you arrive for your visit, please be ready to present your current insurance card and co-pay (due at time of service). Please bring all of your current medications with you. If you bring a list, be sure it's up-to-date and includes medication names and dosages.


If you need to cancel an appointment, kindly provide 24-hours notice by calling the office. Please understand that you may be charged a cancellation fee if you do not provide 24-hours notice.


Contact Info


Telephone: 203-244-9529

Fax: 203-648-4172

eMail: PBK Primary Care

PBK Primary Care


Tuesdays and Fridays 8am - 5pm

27 Hospital Avenue

4th Floor Suite 404

Danbury CT 06810



Wednesday 8am - 5pm

850 Straits Turnpike Suite 1

Middlebury CT 06762

Patient Forms

New Patient Registration Form

You can download, print and fill-out the forms ahead of time.


If you cannot access the forms on your device – click on the icon below to download the PDF software.




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Waiting Room Primary Care Danbury CT

Waiting Room Primary Care Danbury CT

Waiting Room Primary Care Danbury CT




Waiting Room Primary Care Danbury CT