Patient Forms

Creekview Pediatrics welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Creekview Pediatrics, you can feel confident and comfortable that you have made the right decision.

To understand what to expect for your child's first visit to our practice, please read through this page.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

• Improving the lives of the children we serve by providing quality care in a child-centered environment.
• Listening to our young patients and their families who we are privileged to serve.
• Guiding our patients along a path of optimal health and wellness.
• Continually pursuing excellence at all levels through continuing education.

What to bring to your first visit?

We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please bring your child's immunization records and be prepared to complete paperwork regarding your family medical history and your child's medical history. Please bring a valid form of ID and your child's insurance card.

Insurance

While we accept most major medical insurances, it is your responsibility to check with your insurance company to confirm that we are in network with your specific plan.

We are currently not accepting any new Medicaid, Amerigroup, PeachState, CareSource or WellCare patients.

We are happy to offer you the option to download, print and complete our office forms to reduce wait times during your first appointment.

New Patient Forms

• Consent For Non-Urgent Pediatric Care
• Initial Health History Questionnaire
• Patient Demographic Form
• HIPPA
• Medical Record Release
• Consent to Obtain Patient Medication History

Patient Forms

• Sports Physical Forms
• Cardiac Risk Assessment Form
• ADHD Teacher Letter - Send a copy of this letter to the teacher with Vanderbilt Forms.
• Parent Initial Vanderbilt - This form to be used for first time ADHD consultations only.
• Teacher Initial Vanderbilt - This form to be used for first time ADHD consultations only. ****
• Parent Follow Up Vanderbilts - This form to be used for follow-up visits for patients that have an established diagnosis of ADHD.
• Teacher Follow-Up Vanderbilts - This form to be used for follow-up visits for patients that have an established diagnosis of ADHD. ****

**** Please note- Teacher Vanderbilt Forms will only be accepted when faxed from school or mailed by teacher directly to our office.

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What to Expect

On the day of your child's first visit to our office, we recommend arriving a few minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining with you to help your child maintain optimal health.