The staff at Pediatric Professional Associates, PC would like to welcome you to our Practice! We thank you for your confidence in selecting our Practice and look forward to providing superior medical care to your child/children.
In order to provide you with the best health care possible, it is important that our office receives a full copy of your child’s health records, including immunization records. You may download and bring a copy of our Medical Records Transfer Form by clicking on the link below. Give this form to your child’s previous pediatric practice and have them forward a copy of your child’s/children’s records to our office.
At your first visit, we will require you to fill out patient information forms. To save time at this visit, you may download and print these forms from home, fill them out at your convenience and bring them to your first appointment. Click on the links below to download.
New Patient Forms
- Registration Form
- Auth to Disclose HIPAA
- HIPAA Privacy Notice
- Privacy Acknowledgement
- Medical Record Auth
- Patient Eligibility Screening Form
- Tuberculosis Form
Annual Well Visit Forms
In order to keep our records up to date, we ask that annually the forms below are filled out and handed in to our front desk.
To save time your annual visit, you may download and print these forms from home, fill them out at your convenience and bring them to your appointment. Click on the links below to download.