New Patient Forms

If your child is a new patient, welcome! We are thrilled to know you entrust Pediatric Health Care with your child.  Please download and print the following forms to be brought with you at your initial appointment.

• New Patient Form
• Health Questionnaire

Teen Authorization

• Teen Authorization Form

Record Release Form

If you are exiting the practice and need to have records sent to your new physician, a medical record release must be completed.

• Record Release Form