Prior to your first appointment, please complete the following form and bring it to your appointment

Some things to know...

Appointment time:  Please arrive 15 minutes prior to your appointment to complete the registration, co-payment collection, insurance verification, and medical triage.

If you arrive later than 15 minutes after the scheduled appointment, you may be requested to reschedule the appointment for a later time or date.

Please note, because we try to run on time as best we can, we cannot accept walk-ins.  However, appointments for urgent medical problems are available daily.  If your child as an urgent medical problem, please call us for a same day appointment.

Forms (School/Daycare/Camp):  Please allow us 3 business days to complete your form.  Your child must have an updated physical exam in order for us to complete the form.  There is a $10 fee for all forms, and a $25 fee for forms needed sooner than 3 business days.

Co-payments and deductibles:  Please note that your co-payment and/or deductible must be paid at the time of service. We cannot send the bill at later time.  Please call your insurance carrier to verify if you have any deductible or any other responsibilities.

Disclaimer- No show policy:  You can change or cancel your appointment free of charge at any time. Once the appointment is made you will receive an automatic confirmation with options to change or cancel your appointment. There is no fee or charge for making, changing or cancelling the appointment.

However, should your child not come for the scheduled appointment without cancellation, change of appointment or any notification of the practice (i.e. no show visit) you will be subject to a $30 dollar “no show” fee. By making this appointment you acknowledge and express agreement to this policy.

Newborns:  If you have a newborn, make sure to add your child onto your insurance within the first 30 days of life in order to avoid denial of coverage.