Parents of new patients are invited to use our forms below and download the required forms we must have on file for your child. Please fill them out completely and bring them to your first appointment.

Required Information Check-In List

• ALL patients must present their insurance cards in order to update our records and ensure correct billing address
• All new patients must be accompanied by a parent or legal guardian
• Current completed information packet with third party consent
• Driver’s license of parent who presents with child
• Driver’s license of authorized third party
• Signed HIPAA receipt form
• Signed TVCP (Vaccine authorization)

Children’s Clinic Forms

• New Patient Form
• Patient Info Form
• Required Information Check in list
• Medical Info Form
• Family Medical Info Form
• Medical Info Release Form
• Authorization of Third Party Form
• Notice Concerning Complaints Form
• Treatment Form
• TVFC Screening Form
• HIPAA Form
• ImmTrac Form
• Health Insurance Claim Form
• Texas UIL Pre-Participation form

Helpful Resources

We strongly believe in continuing medical education regarding children’s health issues and have provided links to the Academy of Pediatrics and Healthy Children. We recommend you visit these websites and documents to become more knowledgeable about children’s health issues as well as the latest information on immunization schedules and vaccines.

• Well-check Up Schedule
• American Academy of Pediatrics
• Immunization Schedule
• Healthy Children
• Expected Duration of Exclusion from School or Daycare
  
• Dosing Chart
• Water Safety Video