Thank you for choosing Surfside Pediatrics as your child's medical home, where we always provide a comfortable, caring environment so our patients and their families can feel at ease. We've included helpful items on this page to ensure you and your child's first trip to our office is productive, stress-free and enjoyable.
Please bring to your first vist:
- Insurance card/infomation
- Previous vaccination record
Our Mission
Surfside Pediatrics is dedicated to providing you with the highest level of pediatric care in a family focused enviornment.
Patient Forms
To expedite your first appointment, please arrive a few 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. You can also email them to: [email protected]
New patient forms
- Patient Information Form
- Financial Policies
- HIPAA Notice of Privacy
- Transfer of Medical Records Form (releasing records TO our office)
Newborn forms
Other forms
- Transfer of Medical Records Form (releasing records FROM our office)
- Consent for treatment of a minor (this form allows a grandparent, babysitter, or someone besides parent to bring in pt)
- Consent for exchange of mental health information (from one of our providers to an outside therapist)
- 18yr consent form (grant permission to realsae medical information to your parent)
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What to expect
A pleasant, comfortable first visit builds trust and helps put the child at ease during future visits. We want your child to enjoy getting to know our doctors and staff, so we work hard to establish this bond during every appointment to our office. During your initial appointment, we will explain everything in detail and answer any questions you may have.
We look forward to meeting you and your child and providing the quality, comprehensive medical care you expect and deserve.