Pediatric Care Information
Well Child Care
Click on which age span you would like more information on:
|Birth to Two Weeks||12 Months|
|Two Weeks to Two Months||15 Months|
|Two to Four Months||18 Months|
|Four to Six Months||2 Years|
|Six to Nine Months||3 Years|
|Nine to 12 Months|
By completing and printing the necessary forms prior to your arrival will speed up the check in process.
- New Patient Information Form / Forma de Informacion de Paciente Nuevo
- Health History Information Form
- Medical Records Release Form / Practicas de Privacidad
- Payment Policy / Practica de Pago
*NOTE: If you are transferring from another facility to ours, please fill out this form and send/fax it
to the other facility so they may send your records to us.
- HIPAA Privacy Practice Notice / Aviso de Privacidad
Patient Eligibility Screening Record / Expediente de Investigación de Elegibilidad del Paciente
- Adobe Reader 5.0 or higher is required to view and print the forms.
Click here to get Adobe Reader.