Welcome to the Healthy Kids Pediatrics Patient Information Center.
In this section are resources which may help make your visit go more smoothly and efficiently.
For new patients, there is information about our practice which can be printed out and brought with you at your first visit.
For our established patients, there are copies of forms for a variety of situations including school physicals. Preprinting some of these may be helpful.
Bear in mind that we give you a copy of your child’s Universal Child Health Care Record or part B of the Athletic Pre-Participation Physical Examination Form which have been preprinted with much of your information, at every physical exam.
Under the Educational Info menu, you will find helpful information which has been written by the the HKP Team. Under the Educational Resources menu, you will find many useful sites that we have chosen for you as well.
Information for New and Prospective Patients is outlined below.
Prior to your first visit, we would like you to complete new patient forms so that we may obtain all previous records you or your child may have.
Prior to your first visit, we would like you to complete new patient forms so that we may obtain all previous records you or your child may have. Should you have any questions about this process, please contact the office at 844-437-5455. It would be helpful if you downloaded and filled out the packet below.
The new patient packet includes the following information. Please print out and complete these forms prior to arrival
- Family Information Sheet
- Insurance Information Form
- Financial Policy Acknowledgement Form and Waiver **
- HIPAA Policy Acknowledgement Form
** Please do not sign this form until you have read all the sections of the Financial Policy above.
- Universal Child Health Care Record
Provided for Grades K through 5 .
- Athletic Pre-Participation Physical Examination
Please print out this form and complete the History (Page 1, complete page 2 for children with disabilities) before you bring your child for a physical exam. (6th grade and older) Pages 3 and 4 will be provided.
- New York Health Certificate and Appraisal
Most NYS schools accept the NJ form, but you may bring this if yours does not. Please prefill demographic information