Community Primary Care a Division of Premier Medical Group
  • Providers
    • Ralph Gargiulo, PA
    • Christos Kyrou, DPM
    • Christopher George, M.D.
    • Eleanor Ana Sigalas CCM, AGNP-C
    • Grace Silverio, FNP-BC
    • Linda Ruta, FNP-C
    • Meredith Calderon, FNP-BC
    • Meera Lobo, M.D.
    • Lex Harvey, FNP-C
    • Kim Hardwick, PA
    • Ravichandra Reddy, M.D.
    • Hong Chen, NP
    • Rabi Sinha, M.D.
    • Laura Varlaro, DMSc-PA
    • David Walker, M.D.
  • Services
    • Laboratory Testing
    • Radiologic Imaging Services
    • Phlebotomy
    • Cardiovascular
    • Podiatry
    • Pulmonary Testing
    • Coumadin Clinic
    • Travel Vaccinations
    • Immigration Physicals
    • DOT/CDL Physicals
  • About Us
    • Medical Home
    • Why Choose Us?
    • Careers
    • Patient Testimonials
  • Patient Forms
  • News
  • Resources
    • Patient Education
  • Contact Us
  • Facebook
  • Insurance
  • Patient Portal

Monday – Friday: 8:00am - 5:00pm Extended Hours 5:00pm - 7:30pm
Saturday: 8:00am - 5:00pm Sunday: 8:00am - 5:00pm

845.226.4590
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  • Twitter

Patient Forms

Below are a list of Community Primary Care Patient Forms. Click on each link to view, download or print each form.

New Patient Forms

  • New Patient Demographics Form
  • Notice of Privacy and Practices Consent Form
  • Notice of Privacy Practice

Other Forms

  • DNR
  • MOLST
  • Handicap Form
  • Healthcare Proxy
  • Living Will
  • New York Motor Vehicle No-Fault Insurance Law Assignment of Benefits Form

Patient Release Forms

  • Patient Records Release TO Community Primary Care
  • Patient Records Release FROM Community Primary Care

Forms in Spanish

  • Healthcare Proxy
Patient Testimonials
Dr. Sinha's care has continued over the years

Dr. Rabi Sinha was our first doctor for both my husband (since deceased) and myself. He has gotten to know...

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...

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Dr. Sinha's Patience and bedside manner are immeasurable

Dr. Sinha has been my primary care physician for over 15 years. I have complete trust in him! He...

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Community Primary Care a Division of Premier Medical Group
  • Home
  • Providers
  • Services
  • About Us
  • Patient Forms
  • News
  • Resources
  • Contact Us
  • Patient Portal
  • Insurance
  • Privacy Policy
  • Rabi Sinha, M.D.
  • David Walker, M.D.
  • Laura Varlaro, DMSc-PA
  • Ralph Gargiulo, PA
  • Grace Silverio, FNP-BC
Office Hours:

Monday – Friday: 8:00am - 5:00pm Extended Hours 5:00pm - 7:30pm
Saturday: 8:00am - 5:00pm Sunday: 8:00am - 5:00pm

Community Primary Care a Division of Premier Medical Group

45 Foster Road Hopewell Junction, NY 12533
Tel: 845.226.4590 / Fax: 845.202.5155

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We are Accepting New Patients Call or Text us today 845-226-4590