Forms
Demographic forms You must fill out a demographic form if your insurance or address has changed since your last visit. If your personal information is the same, you will be asked to update the form once a year to help keep our records current. All foster parents must include their Social Security number on the demographic form in order for their foster child to be seen by a doctor.
Medical forms Allow the doctors 2 to 3 business days to complete any athletic, day care, medication and physical forms. Please call before you return to pick up your form. We currently fax the following forms: WIC, pharmacy refills and school medication forms.
Medical records A release of information form must be completed if you need us to forward your records to another doctor. If a parent or guardian needs a copy of medical records there is a fee.
Back to Good Hope Pediatrics home page. |