Patient Forms
To help save time during your visit, we’ve made our most commonly used forms available for download. You can fill them out at home and bring them to your appointment.
How to Fill Out Your Forms:
- Digital Option: Forms can be completed on your computer, then printed and signed.
- Handwritten Option: If you prefer to fill out forms by hand, please use black ink only (no gel pens, please).
New Patient Forms
If you’re new to Great Destinations Pediatrics, please complete the following before your first visit:
- New Patient Packet
- Patient Registration Form
- HIPAA Authorization & Release
- Consent for Treatment & Testing
- Web & Social Media Authorization
Patients 18 years and older: Please complete the Adult Patient Packet (18+) .
Records & Billing Forms
Use these forms to request records or manage your billing information: