Patient Forms

Before your child's first visit, please complete the new patient forms below and bring them with you to the appointment.

New Patient Registration Form
Click on the image to the left to view the form.

Medical Release Form
Click on the image to the left to view the form.

You must have the free Adobe Reader to view these forms. Get Adobe Reader.

Office Policies

Consumer Fact Sheet
Click on the image to the left to view the form.

Office Policies 2011
Click on the image to the left to view the form.

 

Parent Resources


 

http://kidshealth.org/parent/index.jsp?tracking=P_Home

 

Support Groups

  • Grief Works
  • Home Schooling
  • Cleveland Clinic Epilepsy Support

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    Diseases & Conditions

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    Before your child's first visit, please complete the new patient forms listed below and bring them with you to the appointment.

    To read and/or download our Notice of Privacy Practices, please click here or request a copy when you sign in at the office.

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    Fusce feugiat malesuada odio. Morbi nunc odio, gravda at, cursus nec, luctus a, lorem. Maecenas trque orci ac sem. Duis ultricies pharetra magna. Donec accumsan malesuada orci. Donec sit amet eros. Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Mauris fermentum dictum magna Sed laoreet aliquam leo. Ut tellus dolor, dapibus
    Praesent vestibulum moltie lacus. Aenean nonmmy hendrerit mauris. Phasellus porta. Fusce suscipit varius mi. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Nulla dui. Fusce feugiat malesuada odio.

    Morbi nunc odio, gravda at, cursus nec, luctus a, lorem. Maecenas trque orci ac sem. Duis ultricies pharetra magna. Donec accumsan malesuada orci. Donec sit amet eros. Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Mauris fermentum dictum magna Sed laoreet aliquam leo.

    Multimedia Library

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    Immunizations


    First Choice Pediatrics follows the immunization guidelines recommended by the American Academy of Pediatrics (AAP). For information about these vaccines and the diseases they protect against, please click here.

     

    Billing

     

    Billing Information
    Click on the image to the left to view the form.

     

     

    Monthly Tips

    Under Construction
    Under Construction

    Under Construction

    Patient Portal

    To Access your Medical Records
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