Patient Forms

If you would like, please feel free to fill out your patient registration and privacy forms in advance of your visit.

PDF_icon  Mountain Pediatrics Patient Information

Please use the link below to review our Privacy Notice or request a copy when you sign in at the office.

PDF_icon  Mountain Pediatrics Privacy Policy Notice

If you have the need to transfer your records from another medical practice, please use the link below to request a records release.

PDF_icon  Mountain Pediatrics Medical Records Release 

Please take a moment to review our office policies so that you familiar with the practice and payment expectations.

PDF_icon  Mountain Pediatrics Office Policies

Office Policies

We take both scheduled patients and emergency walk-in visits. Please call us as soon as possible so that we can try to appropriately schedule your time with us. We will always try very hard to accommodate our schedule to meet every patients needs, but in order to see our scheduled patients on time we ask that you respect certain policies.

Please understand that walk in visits are for emergencies, we cannot do well visits, camp/sports physicals, or medication refills on a walk in basis, you may be asked to schedule an appointment for a different time if we cannot see you when you arrive.

If you need walk-in urgent care, please realize that you may have to wait until we can find an opening in the schedule so that we can see you without disrupting patients have already scheduled appointments. We will make every effort when you arrive to estimate how long your wait might be.

We ask that all of our families understand that emergencies happen, we want to see everyone on time, and as quickly as possible, however even the best planning cannot account for every possibility. We respect and value your time, and we are working as quickly as possible to help you.

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