New Patient Forms (Electronic Option)

We welcome you to our practice and we look forward to providing the best service to you and your family.

What to do before your first visit:

  • Visit our Billing/Insurance page, under Resources, to verify that we accept your insurance.
  • Call your insurance carrier and change your child’s primary care physician to one of our providers.
  • Request your child’s Medical & Immunization Records from your previous physician. You can use our Records Release From Previous Practice. Fill out this form and fax it to your previous practice to request your child’s records.
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  • Read our Notice of Privacy Practices Form.
  • Fill all forms below prior to your visit:

    (We will need one Demographic form, and one Past Medical History form filled out for each patient)

    - Demographic Form(Fill One Per Patient)

    - Consent To Treatment (Fill One Per Family)

    - Family History (Fill One Per Family)

    - Past Medical History (Fill One Per Patient)

    • Once we receive a copy of your records and these forms are completed, we will contact you to schedule an appointment.
    • Remember to bring your child’s insurance card so that we can scan it for our records.
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