904.223.9100

Patient Forms

Patient Forms 

If you are a new patient to our practice,

Please pre-register with this link and we will call you to schedule your first appointment.

Please remember to bring your insurance card and a photo ID. If you have any record of your child’s immunizations, please bring those to your first visit. Not having previous vaccination records may delay your child getting important immunizations at that visit if needed. If you do not have any records, please come prepared to fill out a release with all past physicians’ phone numbers and addresses.

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ADHD Consults

We prefer you login to CHADIS online, available through our home screen to complete forms and email forms to teachers as these upload directly to your child’s chart.

Invitation code: Rainbowpeds. Once logged into CHADIS you can even email multiple teachers links to complete questionnaire’s.

ATTENTION

If your child is coming in for a Sports Physical and/or need sport-related forms completed at your well child exam, please print YOUR CHILD’S Sports Physical History Form, complete it and bring it to your appointment.

If you print out any forms PLEASE REMEMBER to bring them with you to your child’s visit!