New Pediatric Patients

We are excited that you have chosen Children's Medical Center for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.

Patient Forms

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.

*Forms Currently Under Construction*

Forms Packet

  • New Patient Forms Packet 
  • Newborn Patient Forms Packet 

Individual Forms

For your convenience you may download and print our forms individually. Please bring the completed documents to your first visit.

  • Patient Contact Form
  • Medical Release Form to obtain records
  • Medical Release Form to release records
  • Medical Treatment of a Minor Authorization Form
  • HIPAA Notice of Privacy Practices
  • Financial Policy
  • Pharmacy Update
  • Patient Appointment Cancellation and No Show Policy
  • Forms Charge Policy
  • Consent Agreement Treatment
  • Children's Medical Center Vaccine Statement

Patient Grievance

  • Patient Grievance Policy
  • Patient Grievance Form

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