Ansonia Location

  • 560 Main St. | Ansonia, CT 06401 |
  • (203) 735-7079

Southbury Location

  • 30 Quaker Farms Road | Southbury, CT 06488 |
  • (203) 262-4162

    Dr. Richard B. Kaplan

    Patient Forms

    Please take a minute to print and fill out the patient information form before your first appointment:

    • Patient Form (Child) PDF | DOC
    • Patient Form (Adult) PDF | DOC
    • Patient Form (Child & Adult) PDF | DOC

    If you're unable to open PDF files, you can get Adobe Reader® for free.

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