Fill this out and we’ll call you very shortly after to get your child set up.
Mon / Wed / Fri: 8 AM – 5:30 PM
Tue / Thu: 8 AM – 7 PM
Saturday: 8 AM – 1 PM
Plus a doctor on-call Sundays for emergencies.
We work with most major plans so your child’s care is covered from day one, including Fidelis Care, Highmark BlueCross, Excellus, Independent Health, Aetna, Cigna, Molina, Univera, and more.
Fill this out and we’ll call you very shortly after to get your child set up.
Before completing this form you will need:
One form per child please.
Please note, Patient records must be received prior to the scheduled appointment. Appointments will be rescheduled if they have not been received.
A NYS DOH Release of Health information form, can be printed and submitted to the previous PCP. A release of records can also be filled out at your previous PCP office.
Here’s what happens after you fill out the form.
Within 1 business day, our team calls to find a time that works for your schedule.
We’ll walk you through everything you need so your child’s first visit goes smoothly.
Century-Airport Pediatrics, P.C.
Our Lady of Victory Campus. 790 Ridge Road, 1st Floor, Lackawanna, NY 14218
Phone: (716) 893-7337 | Sick Line: (716) 893-7265 | Fax: (716) 893-7699
Mon / Wed / Fri: 8:00 AM – 5:30 PM | Tue / Thu: 8:00 AM – 7:00 PM | Sat: 8:00 AM – 1:00 PM
After-Hours Emergency: (716) 695-7015
© 2026 Century Airport Pediatrics. All rights reserved.