FORMS

Need to schedule a wellness check up or physical?

New Patients, Start Here!

If you need to schedule a wellness check up or physical, also complete the link above.

Additional Forms

 Release of Records

      Have records sent TO Ideal Pediatrics.

      Have records sent FROM Ideal Pediatrics to another facility       

    ($10 handling fee, 10 cents per page if paper copies, May take up to

     3o days. Expedited fee for under 48 hours, $25. Once your signed form is

     received, you will receive a text with a link for payment)

     State information on reasonable charges for transferring medical records.

PHI info