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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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 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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Laura Varlaro has helped me for many years

I have been more than comfortable with all of Laura Varlaro's medical skills. She has diagnosed some very complex conditions...

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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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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