Cute little baby boy, relaxing in bed after bath, smiling happily, daytime

New Patients: Pediatric Care Specialist

 

Choosing a pediatric care specialist for your children is one of the most important decisions you can make. You want a physician that is caring, knowledgeable, and accessible—a doctor that is willing to take the time to go over all of your medical care options, answer questions, and treat you and your child as people, not just a chart.

New Patient Pediatric Care

Since Pediatric Care is a smaller practice, we try to know and treat our patients individually. At Pediatric Care, we pride ourselves on our services to our patients. If you are looking for a pediatrician or family nurse practitioner in the Provo, Orem, and Utah county area, call Pediatric Care today.  Our staff is knowledgeable, attentive, and easy to contact. We educate our parents and patients, use safe and proven procedures and use the latest medical technology. You can be sure your children will receive the highest standard of care at our office.

Your First Visit

To ensure your child receives the best possible care, Pediatric Health encourages new patients to have their children’s previous medical records transferred to our office, if they have any.  In order to do this, patients will need to fill out the Medical Records Authorization form.

To save you time on your first visit, Pediatric Health recommends filling out the digital “New Patient Form” located on this page.  If you prefer to complete the form by hand, you may print the PDF version.

On your first visit we will also need you to bring in your insurance cards, immunization records and social security numbers for both parent/guardians and children.

New Patient Form

Before completing the form, please view our privacy policy.  Once you have submitted the form, you will receive a copy via email for your records.

  • Patient Information

  • MM slash DD slash YYYY
  • Patient's Immunization Record(s)

  • Max. file size: 128 MB.
  • Max. file size: 128 MB.
  • Max. file size: 128 MB.
  • Legal Guardian's Information (if applicable)

  • You will need this information when you come.
  • MM slash DD slash YYYY
  • You will need this information when you come.
  • MM slash DD slash YYYY
  • Insurance Information

  • You will need this information when you come.
  • You will need this information when you come.
  • Copy of Insurance Card

  • Max. file size: 128 MB.
  • Max. file size: 128 MB.
  • Referral Information

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