Referral form
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Bay Shore Pediatrics Referral Form
Referrals can only be given to existing patients.  Referrals to a specialist are given after a
patient has been evaluated in the office for the particular diagnosis.  If you are a new patient
to Bay Shore Pediatrics, please schedule an office visit prior to requesting a referral.  
Please allow 7 days for us to process your referral.  You can either call our office during
office hours for a referral or download our referral form and fax it to our office at
410-414-4662.
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