We welcome new patients to our practice and offer the forms necessary that can be printed from our website. On the day of your first visit we recommend arriving a few minutes early to allow time for finishing any registration forms and to become acquainted with our office.
If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit:
- Insurance cards and drivers license
- Complete immunization records
- Medical records from your previous pediatrician
Patient Forms
We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit.
New Patient Forms
- Patient Information Form [PDF]
- Record Release Form [PDF]
- HIPAA [PDF]
- Office Policies [PDF]
- PCMH Agreement [PDF]
- Vaccine Statement Policy [PDF]
Miscellaneous Forms
- ADHD INITIAL VISIT PARENT [PDF]
- HEALTH APPRAISAL UP AGE 9 [PDF]
- PHQ-9 FOR ADOLESCENTS [PDF]
- SCARED FILLED OUT BY CHILD [PDF]
- SCARED FILLED OUT BY PARENT [PDF]
- ASTHMA CONTROL TEST 12 YEARS AND OLDER [PDF]
- ASTHMA CONTROL TEST AGES 4-11 YEARS [PDF]
- ADHD FOLLOW UP TEACHER [PDF]
- MHSAA HEALTH APPRAISAL [PDF]
- ADHD FOLLOW UP PARENT [PDF]
- ADHD INITIAL VISIT TEACHER [PDF]
Click here to download it.
Directions
Beaumont Medical Center at 1455 S. Lapeer Rd., Suite 134, Lake Orion 48360
Phone number:
248-683-3385
Fax number: 248-690-7389
Answering Service for after-hours:
248-
683-3385
