• 90 Millburn Ave Suite 101 Millburn NJ 07041


We believe immunizing children is one of our most important roles as pediatricians. While respecting those who choose not to immunize, our practice does not accept patients who refuse to vaccinate. In the event you change your mind and accept vaccines for your child in the future, we will welcome your child as a patient.

Medication Management

Patients on behavioral medications must schedule a follow up appointment 30 days after the initial treatment and every 3 months thereafter. Due to certain restrictions of these drugs, we generally cannot replace prescriptions if “lost.” If the doctor agrees to reissue a prescription, a $5 fee will incur.

Picture Taking and Recording

To protect the privacy of our patients and staff, we ask that you refrain from picture taking and recording unless approved by management.

Forms, Letters & Narrative Summaries

We charge $10 for every form and letter produced for third parties not part of insurance coverage (i.e., schools, Social Security office, airlines, utility companies, etc.).

Forms and letters will require 5 to 10 business days to be completed depending on the season.

There will be an Express fee of $15 for forms that are needed prior to five business days, and $20 for forms needed within 24 business hours.

Forms cannot be completed on weekends or weekdays after 5 PM. Upon receipt of payment, completed forms or letters can be picked up or mailed if a self-addressed stamped envelope is provided.

March through September is our busy “form season.” To avoid last-minute rushes, please learn our policy, and submit your forms and letter requests to us as soon as you receive them.

Completed forms are nonrefundable.

We charge $150 for the completion of a narrative summary.

Medical Records

$20 for each of the first two patients. $10 for each additional patient. We accept cash, check and all major credit cards.

Requests for entire records will take up to ten business days to complete. The record release process will begin once payment is received. Entire records cannot be faxed. The request must be submitted to us in writing by completing our Outgoing Record Release Authorization form.

Completed forms are nonrefundable.

NJ State Medical Record Law requires medical doctors to retain medical records for 7 years from the date of the most recent entry. Our office will keep medical records for up to 10 years after which they will be destroyed.


Please allow at least 2 to 3 business days for a referral request to be generated. We also require 5 to 7 business days to process prior authorizations and letters of medical necessity.

No Show

We charge $25 for not cancelling 24 hours in advance & not showing for your scheduled appointment.


We accept cash, checks and major credit cards.  You have the opportunity to make a special payment arrangement by providing us your credit card information.   Confidentiality will be strictly observed. See our Easy Pay consent form.

Additional Statements

There is a $10 processing fee per request for additional statements. (For example, a flexible spending year end summary). We encourage patients to keep their receipts throughout the year.

Returned Checks

A $35 return check fee is charged to those who have written checks that are unable to be cashed by the bank. The patient owes the original amount for which the check was written.


A $10 surcharge will be added if you copay is not made at the time of service.