Alpine Medical Group Pediatrics

Is Your Child Sick?^TM

Forms & Policies

You can save time at your visit by doing any necessary paperwork before you arrive.
If you have been asked to fill out any of the following forms, please print and fill out at
home. New patients should complete the 3 forms below. Remember to also bring your insurance card, ID, and copayment!

Forms

No one likes filling out forms! We try to keep our forms as simple as possible, but we
really do need all of this information for all new patients. We also need you to complete
a new "patient information" if you move, your insurance changes, or if your previous form
was completed more than 3 years ago. Printing these at home and bringing them to your appointment can help your visit run more smoothly.

Patient Information
Family History
Child/Social History

Informacion Del Paciente

Policies

Please read through our office policies if you are new to our clinic.

Privacy Practices
Financial Policies
Arbitration Explanation
Arbitration Agreement

Aviso De Privacidad
Regla Financieras
Explication Escrita De Arbitraje
Acuerdo Para Arbitraje Medico