The following forms are provided to help make your visit to Partners in Pediatrics as convenient as possible. On this page, you'll find information about our general office policies as well as links to some of the forms that you can print and fill out before your appointment.
Our forms are in Adobe format. You may download Adobe Reader for free at Click to download Adobe Reader
Our Policies:
Medical Records
- Medical Record Release Form (For transfers out of our office or requesting records)
- You may also access your medical records on our patient portal.
New Patient Forms:
For all new patient questions or concerns or to confirm that we are accepting your insurance plan, please call our office at 334-272-1799.
We can guide you on selecting an available doctor, how to have your records transferred and what information we will need to schedule your first appointment. Appointments are scheduled after we have received your medical and immunization records.
- Welcome to Partners in Pediatrics
- Request for New Patient Appointment
- New Patient Registration Packet (To be completed prior to new patient appointment)
- HIPAA Notice of Privacy Practices (Review only)
Additional Patient Forms:
- Patient Update Form (For established patients only - to be completed every 6 months or with any changes to information)
- Patient Portal Instructions
- Asthma Questionnaire
- Nine Month Questionnaire
- 24 Month Questionnaire