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609 Price Ave # 104
Redwood City, CA 94063
650-365-1109
650-365-6138 non-urgent voicemail
650-365-7720 fax

Patient Forms and Information - Redwood City

Pediatric Associates welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Pediatric Associates, you can feel confident and comfortable that you have made the right decision.

To understand what to expect for your child's first visit to our practice, please read through this page.

Patient Forms

To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment or you may fax any paperwork to 650-365-7720 (24 hours).

• Welcome Packet
• New Patient Registration
• Patient Partnership Plan/HIPPA
• Medical History
• Pre-Participation Physical Evaluation (Required for all well physicals 11 and above.)
• Vanderbilt Assessment for Parent
• Vanderbilt Assessment for Teacher

Release of Medical Records

• Authorization for Release of Medical Records
• Release of Records Fee Policy
• HIPPA Privacy Notice
   

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to expect

A pleasant, comfortable first visit builds trust and helps put the child at ease during future visits. We want your child to enjoy getting to know our doctors and staff, so we work hard to establish this bond during every appointment to our office. During your initial appointment, we will explain everything in detail and answer any questions you may have.

We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.

New Patients

We require medical records prior to seeing any new patient. If it is for an illness visit, we require vaccine records, if it is for a well exam we require full medical records. A release of records is available on this site as well as all new patient forms for your convenience. This form should be forwarded to the physician you are requesting records from.
If your child is 11 years old or older, he/she will need to fill out a questionnaire at each physical. This form is available on this site as well. It should be completed by your child.

Directions

We are next to the Department of Motor Vehicles, exit Whipple at 101.

CONTACT US

Questions or Comments?
We encourage you to contact us whenever you have an interest about our services.