School Health Program Registration Packet

To register for the School Health Program, click on the appropriate link below based on your child’s grade and/or school. Print the packet, fill out the forms completely, and sign and date all forms. Keep the last page (Summary – Notice of Privacy Practices) for your own records. Please submit the rest of the packet to the school-based health center at your child’s school.

Parent Consent Packets

To be completed by parents of students at P.S. 38, Dream Charter School, P.S. 83, BBMS/P.S. 182, P.S./M.S. 108, Esperanza Preparatory Academy, Global Neighborhood Secondary School, and Talented and Gifted School:

To be completed by parents of high school students at Esperanza Preparatory Academy only:

Student Consent Form

To be completed by high school students at Esperanza Preparatory Academy only:


Contact Us

For information or to make an appointment

Dentistry Practice 
Tel: 212-659-8528

Eye Care Practice
Tel: 212-241-7676

Geriatrics Practice 
Tel: 212-426-0349

HIV/AIDS Practice 
Jack Martin
Tel: 212-241-7968
Comprehensive Health Downtown
Tel: 212-604-1701

Internal Medicine Associates
Tel: 212-659-8551

Kidney Care 
Tel: 212-987-7208
For other locations

Medical & Surgical Specialty Practice
Tel: 212-659-8554

OBGYN Practice
Tel: 212-659-8557

Palliative Care
Tel: 212-426-5054

Pediatrics Associates
Tel: 212-659-8559

Rehabilitation Medicine
Tel: 212-824-7633

School-based Health Program
Tel: 212-241-1543