If you wish to transfer your care to our practice, please complete these forms.
- Patient Information Form
- Insurance Waiver Form
- Authorization for Vaccine Administration
- Family History Summary
- Medical History Form
We request that you also obtain your previous medical records for our physicians to review. This will afford you the best possible medical care. We must have your previous vaccinations records by the time of your visit. Ideally these will be submitted to us prior to your appointment so they may be documented. Thank you for choosing Centre Pediatric Associates, PC.