Jacksonville Kids Pediatrics welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Jacksonville Kids Pediatrics, you can feel confident and comfortable that you have made the right decision.
On the day of your child’s first visit to our office, we recommend arriving 15 minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining you to help your child maintain optimal health.
Our Mission
Jacksonville Kids Pediatrics, Where Parents and Pediatricians are Partners.
Patient Forms
To expedite your first appointment, please arrive 20 minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.
- New Patient Packet (ALL FORMS)
- Cancellation Policy
- Notice of Privacy Practices
- Acknowledgement of Privacy Practices
- Medical Records Release
- Authorization for Treatment
- Medical History
- Surgical History
- Medication/Allergy History
- Family History
- Social History
- Financial Policy
- Vaccine/Well Visit Schedule
- EKG Waiver
In order to view or print these forms, you will need Adobe Acrobat Reader installed. Click here to download it.
Directions
- Conveniently Located to the Beaches and St. John's Town Center.
- Our office is on Jacksonville's southside, off of 9-A and Gate Parkway.