Forms
Compassionate Care for Every Stage of Childhood
We provide easy access to all necessary forms online to make your visit as smooth and efficient as possible. Completing these forms before your appointment will help us reduce wait times and ensure your child receives the best possible care.
FORMS & FILES
Welcome to Pediatrics & Urgent Care! We’re passionate about providing outstanding healthcare for infants, children, and adolescents. Our caring team of pediatricians is devoted to ensuring your child receives top-notch medical care in a welcoming and nurturing setting.
Please carefully review and complete all the information in this packet before your first pediatric primary care appointment. Being well-prepared will help the healthcare provider better understand your child’s medical history and specific needs, ensuring a more productive and beneficial appointment.
Before or upon your arrival at our urgent care center for your first visit, please take the time to complete this form. Your cooperation is invaluable and ensures we can provide the best care.
Hey there! Just a quick reminder to finish up your section of the sports physical form for the LA Unified School District before your appointment. I appreciate your cooperation!
To provide uninterrupted care, please grant consent for us to retrieve your records from another clinic or hospital.
Please fill out this form if you need someone to accompany your child when you can’t be there. We’re here to help!
This option enables Medi-Cal patients to afford services not covered by their plan or for Medi-Cal plans that we do not currently accept.
To ensure a smooth vaccination process, kindly complete this consent form.
We’re thrilled to provide our credit card authorization form for you or the person responsible for your care to sign! I appreciate your cooperation.
This important consent form is necessary to receive your annual influenza vaccination. Participation in this vaccination program is crucial for your health and those around you.
Before visiting your house, please take a few moments to complete the attached form. Your cooperation is greatly appreciated. Thank you!
Before we start the exciting journey of ear piercing, please fill out this form to give your consent.
This assessment form is an essential tool to evaluate your child for ADHD.
This essential consent form is crucial for the completion of any medical procedures. Your cooperation is greatly appreciated.
This essential form is pivotal in evaluating your child’s susceptibility to lead poisoning.
This emergency contact list for LA County is here to help in need.
Ready to take control of your health? This form is your first step toward a TB skin test.
Coloring Books
