Important Announcement: New Patient Hold (Effective 8/23/24)
Effective 8/23/24, we will be on a new patient hold. Exceptions to this hold include:
Vaccination Policy: Please note that we do not accept unvaccinated patients. However, we do have an approved alternate vaccination schedule, which is available below.
Insurance and Network Information: It is your responsibility to verify that we are in-network with your insurance plan and that if HMO, we do accept it. This is different from being contracted with your insurance and may result in additional out-of-pocket charges. For more details, please refer to our FAQ/Insurance section or feel free to email us with any questions.
Thank you for your understanding and we are grateful for the support!
Please fill out only if you wish to follow our alternate vaccine schedule.
Alternate Vaccine Schedule (docx)
DownloadFill this out if you are sending your child with a person other than a parent/guardian.
Fill out if your child is 16 & older and you would like to give them permission to be seen without a parent or guardian.
Must be filled out prior to new patient appointment. Our staff will instruct you on where to submit. Thank you!
Milestones - Medical History Form (docx)
Download