2601 E. Main Street Ventura, CA 93003
Phone: (805) 643-7500 | Fax: (805) 643-7510

Office Policies

Office Policies

The following office policies will enable us to serve you better at Surfside Pediatrics.

Visit Policy

Any patient under the age of 18 years old but be accompanied by a parent or legal guardian for any visit or to receive treatment in our office. If you plan to have a relative or caretaker bring your child to Surfside Pediatrics, we require a signed authorization form to be on file in your child’s chart. Please print out and complete the following Authorization to Treat form. This will enable that person to make medical decisions on your behalf during the office visit.

Authorization to Treat Form

Sibling Add-on Policy

If you would like to try to add an additional family member to an already scheduled visit, please call ahead of time to make sure we can accommodate the extra visit.

Copays/Cash Patients

Copays are due at time of service and will not be billed. If your child does not have insurance we offer a cash discount (paid by cash, credit card or check). This amount needs to be paid at time of visit to receive the discount.

Late Arrival Policy

If you are running late for an appointment we ask that you call the office to let us know. Please be advised that calling does not guarantee that you will be seen and may result in a longer wait. To keep on task with our schedule and provide quality care to the other scheduled visits, we are unable to see any patient that is more than 15 minutes late.

Cancelation/No-Show Policy

To ensure that we have enough openings in our schedule to offer our patients we appreciate and require a 24-hour cancelation notice. Failure to do so, or any no-show appointments will result in a $35 fee. This fee is not covered by your insurance and will be your responsibility to pay.

Walk-in Policy

We do not offer walk in appointments for our patients. Please call our office to get your child added to a time slot on our schedule with one of our providers.

After Hours Call

Our website offers many helpful resources to include: Tylenol and Benadryl dosing, Symptom Checker link, hospital and urgent care phone numbers, If you need assistance after office hours (evenings and weekends) please call our office and follow the prompts.

Email Policy

We do not have a secure email at Surfside Pediatrics for communication. Please fax or bring any forms to our office for completion.

Records Release Policy

You may request a copy of your child’s medical records at any time. This request must be made using our Medical Records Release Authorization Form.

Medical Records Release Authorization

Form Policy

We would be happy to complete any form for school entry, sports, medication at school, field trip etc. for a $10 form fee. Please allow a 3-day turnaround time for completion. If you need your form sooner than 3 days, there is an additional $5 “rush fee”. Forms may only be completed if your child has been seen in our office within the last year (365 days) for a well child physical exam (no exceptions).

Unpaid account

Bills unpaid after 90 days will be turned over to a collection agency unless other payment arrangements are made with our office. We are unable to see your child/children in our office until the full collection balance is paid.

Hours of Operation

8:30 am - 5:00 pm
8:30 am - 7:30 pm
8:30 am - 5:00 pm
8:30 am - 5:00 pm
8:30 am - 5:00 pm

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