670 Mall Drive
Portage, MI 49024

 
If you Only Knew...
(269) 327-1900

   
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Getting to Know the Office
Our Physicians
Expectant Parents
Well Child Exams
Sport Physicals
Immunizations
Insurance
Forms
Resources/Health Concerns
Contact Us

New Patients

           Family Information Sheet

           Family History Questionnaire

           Email registration

           Insurance Information

           New Patient History (if not a newborn)

           HIPAA Privacy Policy

Existing Patients

           Release Information to Pediatrics PC

           Release Information to Another Provider

           Family Information Sheet (required by US Government to be updated yearly)

           Sports physicals

                     Common form used by many of the local schools

           ADD/ADHD Evaluation

           Eating Disorder History Questionnaire

           Foreign Travel Questionnaire

 
©2005-2012 Pediatrics P.C. - 670 Mall Dr. - Portage, MI 49024 - (269) 327-1900