Baptist Pediatrics Forms
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Baptist Pediatrics Registration & Insurance Information
Captures patient demographic information, insurance information and authorizes Baptist Pediatrics to prepare and submit your medical bill directly to your insurance company.
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Authorizations and Acknowledgments / Consent for Treatment
Information about Baptist Pediatrics' policies, insurance/billing, authorization for treatment and more.
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Health Care Authorization and Consent For Treatment Of Minors
Authorizes Baptist Pediatrics to deliver medical services and treatment to your child.
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Declaration / Consent for Health Care Status
Authorizes Baptist Pediatrics to release information concerning the status of your health care, including laboratory and radiology results and to discuss your treatment plan with an individual that you name.
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Authorization for Use of Voicemail
Authorizes Baptist Pediatrics to leave appointment, referral and test results information on your voicemail.
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Medical Records Request or Release
Initiates your request to have your medical records sent to another medical provider and/or to request your medical records from another provider be sent to your primary care doctor.