Please print the following form, If a parent/or guardian will not be present at the time of an appointment for a minor child (17 and under).
364 East Main Street Ansonia, CT 06401 P: (203) 734-4806 F: (203) 734-8265
Monday 9:00am-11:45am 1:00pm-5:00pm
Wednesday 9:00am-11:45am 1:00pm-5:00pm
Thursday 9:00am-11:45am 2:00pm-4:00pm
4 Corporate Drive, Suite 384 Shelton, CT 06484 P: (203) 734-4806 F: (203) 734-8265