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Kids Choice Pediatrics LLC

Forms for new patients

HIPPA Policy Form (Adobe PDF File)

Patient Registration Form (Adobe PDF File)

Record Release Form (Adobe PDF File)

Consent for care (Adobe PDF File)




Insurance/Policies


Contact our receptionist to find out if we accept your insurance. We will also ask you about your insurance when you call for your first appointment, so you will know ahead of time if we accept your plan.

If you were unable to keep the appointment kindly give us a 24 hour notice.

If we don't accept your insurance, you might have to pay the whole bill at the time of your child's appointment. For questions about your specific plan, call the office between 9 a.m. to 4 p.m.

We accept cash, and for co-pays and any balance due.