If you’d like to save time in our waiting room, you can access the new patient paperwork here. Simply click on the documents, print them up, and fill them out before your child’s first visit with us. If you have any questions about filling out these forms, please call our office and a Springs Pediatric staff member will be more than happy to help you.
- Pediatric Medical/Dental History
- HIPAA
- Assignment of Benefits
- Financial Policy
- Notice of Privacy Practices
- Non-Disclosure/Language Assistance
ATTENTION: If you speak [Spanish, French, Italian, French Creole, German, Portuguese, Croatian, Greek, Korean, Albanian, Hindi, Tagalog, Japanese, Arabic, Polish, Vietnamese, Chinese, Russian] language assistance services are available to you.
Call 800-368-1019 (TTY: 1-800-752-0093)