Folder Forms & Patient Policies

NOTE: You must have Adobe Acrobat Reader installed to view and print these forms. It is a free download from


Folder Well Child Checks

Includes questionnaires for developmental stages of your child's growth. The M-Chat should be included for 18 months and 2 year well-child visits.

pdf New Patient Registration and Annual Updates Form

We will print a copy of your information at subsequent wellness visits for you to easily make changes. Thank you for completing this one by hand.

pdf Notice of Privacy Practices

This notice describes how medical information about you may be used or disclosed and how you may get access to information

pdf Payment Policy

Answers questions regarding patient and insurance responsibility for services rendered