Community Care Internal Medicine Clifton Park
1783 Route 9, Suite 102
Clifton Park, NY 12065
Phone: (518) 383-4198Fax: (518) 383-0448
Clifton Park Health Park
Controlled Medication Agreement
New Patient History
Patient Authorization — Use this form if coming from an outside physician.
Patient Authorization - Community Care Physicians — Use this form while at Community Care Physicians.
Veronica Cieszynski, FNP-C
Jill Gradner, MD
Samantha Testa, PA