FORMS

New Patient Forms

Welcome to Ideal Pediatrics! We look forward to meeting you and your child. Please complete the following forms so we can begin registering you. Each link is a separate form. Once completed with a form, press submit, then return to this page to complete the next link. 

Once forms have been received, we will reach out to get you scheduled by the next business day. 

New Patient Intake

Office Policies

Covid Policy Update 

Health History

Records Release TO Ideal Pediatrics

PHI info (review only)

Fax: 618-281-8393 

PHONE HOURS: Monday-Friday 8:00-4:30,

Evening and Weekend Appointments Available

Evening and Weekend Appointments Available

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