Pediatric Forms & Policies

Patient Forms

You can save time and paper by filling out these forms before your visit. Please let us know if you are unsure which forms you need to fill out. Thank you!

New Patient Forms:

• New Pediatric Patient Registration Form

• Release Form for Previous Medical Records

• Adult Patient Registration Form

Established Patient Forms:

• If your child needs school forms, please do not fill out a release form. Instead email us at frontdesk@pedsbythesea.com with your child's full name and date of birth.

• Transfer Records From Our Office to Another Doctor/Hospital/Person

• Release Form to Request a Personal Copy of Your Child's Records

Notice of Privacy Practices