We are delighted and honored that you would choose us to provide pediatric care
for your child and your family. Here is some helpful information as you begin your
relationship with our practice.
Insurance
We are on most insurance plans; click here for a list of plans we currently accept;
please call our office if you have any questions. We
will have to verify your insurance coverage prior to or at your first visit. If
you can get us your insurance information prior to your first visit, then this will
shorten your wait time at your visit. Please fill out the new patient
form below and bring it or fax it to our office at (770) 474-0566. (If you
fax it, please bring the original to your first visit). Also please fax us a copy
of your insurance card, front and back sides.
If your plan requires you to identify a Primary Care Provider (PCP), then you need
to call your insurance company and switch to us as your PCP prior to your visit.
Please be aware that this can take up to 30 days.
Newborn infants are usually covered under the mother's insurance plan for the first
30 days. You need to add your baby to your plan before the baby is 30 days old.
So in summary, before or at your first visit we need the following:
If you are not providing any of this information prior to your visit, please
arrive 20-30 minutes early for your first appointment so that we can
complete your information and verify your insurance coverage.
You can also read and sign our Notice of Privacy Practices prior to your visit.
The form is available below.
Medical Records
We will need a copy of your child's medical records, particularly immunization records
and growth data/charts (previous heights and weights). We do not necessarily have
to have this information at your first visit; however, if you are coming for a well-child visit and your child is
due for immunizations, then we must have
a copy of her shot records so we can tell what shots are due at this visit, since
immunization schedules often differ from one practice to another. If you are keeping
a book with your child's shot records in it, then this is sufficient in most cases
for us to tell what shots are due.
It often takes 3-4 weeks to get medical records transferred. In most cases, you
need to submit a written request to your child's previous doctor. We have a form
you can use here on our website; just print and complete the form and fax or mail
it to your child's previous doctor. (You may need to call their office to confirm
receipt of the request and that it is being processed). Some offices have a fee,
so we suggest that you call their office first to see what their procedure is prior
to sending them the form.
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New Patient Forms |
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New Patient Registration Form
If you are a new patient, please complete this form and bring it with you to your
first visit. You may also fax it to our office at (770) 474-0566 (but be sure to
bring it with your first visit as well). |
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Notice of Privacy Practices
If you are a new patient, please read and sign the Notice of Privacy Practices.
You need to bring only the signed last page with you to your appointment.
Click here for more information. |
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Medical Record Request Form
Use this form to have medical records from your child's previous doctor transferred
to our practice. Fill it out and fax or mail it to your previous doctor's office,
or bring it by our office and we will fax it for you. |
Created:
11/1/2004
Last modified: 6/17/2005