PEDIATRICS PC

670 Mall Drive
Portage, MI 49024

 
(269) 327-1900

   
Home
Getting to Know the Office
Our Physicians
Expectant Parents
Well Child Exams
Sport Physicals
Immunizations
Insurance
Forms
Resources/Health Concerns
Contact Us

New Patients

           Welcome Letter

           Family Information Sheet

           Family History Questionnaire

           New Patient History

           HIPAA Privacy Policy

Existing Patients

           Release Information from Another Provider to Pediatrics, PC

           Release Information to Another Provider from Pediatrics, PC

 Update Family Information Sheet (update when you have any changes to address, insurance, etc., or at least once a year)

           Health Appraisal

           Sports physicals

                     Michigan High School Athletic Association Form

                     Common form used by many of the local schools

           Parent Note for ADD Consultation

           Teacher Input for Behavior Problems

           Eating Disorder History Questionnaire

           Nutritional History Questionnaire

 
©2005-2015 Pediatrics P.C. - 670 Mall Dr. - Portage, MI 49024 - (269) 327-1900