North Point Pediatrics offers online access to patient forms in order to help our patients save time by filling out forms before their office visits.

 

At this time, we offer the following forms for your convenience:

 

 

Patient Information Sheet

 

Physical History Form for 9 years and older

NEW PATIENT FORMS - Yearly update forms for Checkups

Record Release Form for Patients Transferring Into North Point Pediatrics

 

 

Record Release Form for Patients Transferring Out Of North Point Pediatrics

 

 

Consent To Treat Form for Patients Not Brought In By Parent/Guardian

 

FORMS REQUEST

Due to the overwhelming demand for physical, immunization forms, etc… we are asking that you give at least 5-7 business days advance notice to prepare the forms. We will do our best to get your information to you as soon as possible.

Thank you for understanding

Form Policy

Physical Forms Requests will require a payment of $10 per form at the time of the request.

Camp forms $10

504 plans will be a charge of $10.

​​​Please allow us 5-7 business days. Once completed, we can have the forms available for you to pick up at the office or we can return the forms to you by mail or by fax.

You do have the option to have the form expedited for a fee of $25 We will get you the form within 2 business days.

 

DISCLAIMER:

The purpose of the website is to provide information of a general nature. It is intended to be used for informational purposes. The information is meant to be consistent with the standard of care at the time of publication. It is not intended to replace or substitute for the medical advice or decision making provided by one's practitioner. All the information on this website is presented as is, without any warranties of any kind, expressed or implied. North Point Pediatrics takes no responsibility for the all inclusive accuracy and content of this website or of the links from this website. Visiting this website DOES NOT establish a patient-physician relationship with any physician or practitioner associated with North Point Pediatrics. Furthermore, one should consult one's own physician for specific advice for one's personal situation.

 

© 2014 by North Point Pediatrics. All Rights Reserved.