Parent Center

Parent Forms & Office Policies

All requests will be processed in 2-3 days. Please call the office at 407-345-9929 if you are requesting a same day appointment.

You may download and print any of our forms listed below before coming to our office.  This will get you out of the waiting room and in to see the doctor a lot quicker!  You may either bring them with you to the first visit, or if you wish, fax them to us before your appointment.

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New Patient Forms

Office Policies

As with any professional office, our goal is to serve our patients efficiently and effectively. In order to achieve these goals, we request that each patient do their part by cooperating with the policies of our practice regarding insurance and payment.

Insurance Information

Personal Pediatrics accepts the following insurances:

  • Aetna
  • AvMed
  • BeechStreet
  • Blue Cross/Blue Shield
  • Cigna
  • Florida Hospital Healthcare System (FHHS)
  • FMH
  • Golden Rule
  • Great-West Healthcare
  • Healthchoice
  • Humana
  • Multi-Plan
  • Oscar Health
  • Oxford Health Plans
  • Private Healthcare System (PHCS)
  • United Healthcare

If you don’t see your insurance carrier in the list above, please contact us at (407) 345-9929 to determine possible participation.


Please view our common FAQ questions below.

A pediatrician is a physician who has a special interest and acquired knowledge of the health needs of infants, children and adolescents by virtue of extensive training in these areas after completion of a formal medical education. Caring for children is distinctly different than caring for adults, since children have unique medical conditions and issues which adults do not face, and their different body size poses some unique treatment challenges. They are specialists in diagnosing and treating diseases and disorders of childhood.

In order for a pediatrician to become board certified by the American Board of Pediatrics, they have an accredited residency program in pediatrics and pass the board certification examination. Board pediatricians have been through this rigorous process to ensure that they have the skills to be a fully-functioning pediatrician. As a parent, it helps to give you confidence that your pediatrician has the necessary knowledge and skills to take good care of; your child.

We see children from birth through 18 years of age.

We are open Monday through Friday from 8:00 a.m. until 5:00 p.m.

  • For your child’s first appointment, please arrive 15 minutes before your child’s scheduled appointment to complete paperwork.
  • All medical records, especially immunization records
  • List of all medications
  • List of allergies to medications
  • Current insurance card
  • Identification such as a driver’s license of parent/guardian
  • Any co-pay amounts due

Yes, our telephones are answered 24 hours a day. After regular business hours, our phones are answered by a nurse triage service. A provider is always on call and available for consultation if needed.

Yes – $20.00.  After-hours calls are intended for urgent medical questions that cannot wait until the following business day. Appointment scheduling, refill requests, test results, billing questions or any call of a non-urgent nature should wait until the following business day.

Yes. We schedule same day appointments for any child that is sick. To best accommodate children for illness care, please call to arrange an appointment with the available provider. All patients are seen by appointment only.

Urinalysis, strep throat testing, influenza testing, mononucleosis screening, and hemoglobin are all available with results while you are still in the office.

Depending on the type of lab test ordered, the results may not be available for 5-7 days. Our providers will always call with lab results that are considered abnormal or require further follow-up. Should you have concerns, please contact us.

Arnold Palmer Hospital for Children and Florida Hospital for Children have physicians that are specialty trained to care for hospital patients. They will forward all records from the hospital stay to us and your child will follow-up in our office.

Contact our office during regular business hours.

We do not believe it is in the best interest of the patient to prescribe medications over the telephone without first being examined by a provider for the issue at hand.

We recommend that parents call well in advance to arrange a complete physical exam to get their preferred date and time, and to see their preferred provider. For infant well-child visits that are often only months apart, we suggest that parents schedule their child’s next exam before leaving the office.

We have both forms in our office and ask that you give us 24 -48 hours notice for completion. The School Entry Health Exam (DH3040) requires that a physical examination has been performed within the past 365 days. Past immunization history is required for completion of the Florida Certification of Immunization (DH680).

The schools do NOT make these available to us. They must be obtained from your school or coach. Please allow 24-48 hours for completion.

Yes. We encourage expectant parents to consult with us prior to the birth of their child. This lets you establish a relationship with your child’s pediatrician before their birth and get some initial questions answered. There is no charge to the parents for a consultation prior to delivery. Just give us a call to schedule this appointment.

We are honored that you have chosen us to be a part of your child’s healthcare. After delivery, all you have to do is tell the hospital that Personal Pediatrics is your baby’s pediatrician. Call us to schedule your baby’s first visit.

We highly recommend that you have your baby circumcised during the newborn stay at your selected hospital. Discuss this with your obstetrician prior to delivery. We do not perform this procedure in our office.

Yes, co-pays are due at the time of service. In fact, we are obligated by our contractual relationship with the insurers to collect co-pays.

We accept cash, check, debit, Mastercard, Visa, American Express and Discover. We do use the Telecheck service for checks.

We will be glad to file a claim for you once you provide us with the correct insurance policy, subscriber and address needed to do so. Claims are usually filed within 24 hours of your office visit.

Unfortunately, we do not accept Medicaid. We have a listing of the insurance plans we participate with in our insurance section of our web page.

To ensure the privacy of patients and their families and to comply with federal regulations (HIPAA), parents or guardians must sign an Authorization to Release Medical Records form. If the patient is 18 years or older, they must sign the form themselves. Processing of the request can take up to two working days. We release copies of our medical records only. We will not make copies of records from other medical centers. These must be requested from the originating facility.