Forms and Appointments

We provide complete preventive and sickness medical primary care for the pediatrics population up to early adulthood at 21 years of age.

EMERGENCIES:
In case of a medical emergency call 911 immediately.
In case of a poisoning call the poison center hotline at 1-800-222-1222 immediately.

CO-PAYMENTS:
Co-payments are required by insurance companies to be collected at the time services are rendered. We accept cash and credit cards, but unfortunately do not accept checks.

ACCEPTED INSURANCES:
We accept Full Medicaid, most Medicaid HMOs, and all major insurances.

WALK-INS:
Please read our policies.

FORMS:
Please download, complete, and print the Registration forms listed below.

0-1 years old, English Forms

 

0-1 years old, Spanish Forms

 

1-6 years old, English Forms

 

1-6 years old, Spanish Forms

 

7-21 years old, English Forms

 

7-21 years old, Spanish Forms

 

Please bring the above registration froms as well as the following documents with you to your appointments:

1- Proof of medical insurance

2- Valid Photo ID

3- Complete immunization record

4- Previous medical history documents, if available