Please bring the following forms printed, and completed to your first office visit at Etowah Pediatrics along with your insurance card.
- Each new family please fill out this patient demographic form. This is only 1 per family.
- Each new family please fill out this financial/office policies form. This is only 1 per family.
- Each new family please fill out this credit card on file form. This is only 1 per family.
- For children ages newborn to 6 months please fill out this infant medical/social history form for each infant.
- For children ages 6 months and older please fill out this child medical/social history form for each child.
- Please fill out this medical records release as soon as possible so we can request your child’s previous medical records. Medical records must be received before the first visit with our office.
