Register as a Patient
All information regarding parents/guardians, address, dates of birth, contact phone numbers, insurance, insurance ID numbers, and co-payment information is required.
Registration includes a review of privacy practices and a signed acknowledgement of privacy practices (HIPPA). You can access these through the buttons below.
Parents and guardians of pediatric patients have options for registering with Pediatric Partners. They may:
- Print the registration form in the link below and bring to the first visit or fax beforehand.
- Complete the registration information at the time of the first visit. Please arrive 15 minutes prior to the scheduled appointment in order to register.
- Begin the registration process by phone.
The registration process is not complete until signed forms are received and all insurance information is received.