New Patients


Welcome to our practice. For your convenience we have information and forms below. Please read through the information and then print out the forms and bring them to your first appointment.

New To The Practice: What You Need To Know

On behalf of the physicians and staff of Pediatric Associates, we would like to welcome you to our practice. For your child’s first office visit we will ask you to complete or sign the following forms:

  • A Registration form which provides contact information and demographic data.
  • A Medical History form for each of your children.
  • A Health Information Privacy form which stipulates how medical or personal information is shared.
  • For patients other than newborns, we ask that you complete a Transfer of Medical Records form for each child.
  • We will make copies of insurance cards for each of your children.
  • A Billing Policy form requiring payment for any balance not covered by insurance. Our billing department will assist you with any insurance problems that arise.


Please print each of the four documents below, complete, and bring with you to your first appointment.


Below are two specialist lists to which we may refer patients.  Other specialist recommendations will be given at patient appointments as needed.


Vaccine Policy

Contact Us

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