Little Buddies Pediatric Clinic values your time:
In order to save you time in the waiting room, please click on the links below, print, and completely fill out all forms in advance, and bring them at the time of initial visit; otherwise, please come 15-20 minutes before appointment.
For new patients, please fill Patient Information, HIPAA Notice, Financial Policy, and TVFC-Elegibity Forms.
If you need Medical Records to be requested from your former provider, please fill the Release of Medical Information Form.
You can fax the forms, along with a copy of your Insurance Card, to 210.650.0926.
- Patient Information.pdf
- Financial Policy.pdf
- HIPAA Notice of Privacy Rights.pdf
- Vaccine Consent Form.pdf
- TVFC Eligibility Screening Record.pdf
- Release of Medical Information.pdf