New Health Forms — Pediatric Associates, Inc.

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Doctors & Staff

New Health Forms

Billing and Insurance

Prescription Refills

Doctors & Staff

New Health Forms

Billing and Insurance

Prescription Refills

Doctors & Staff

Folder: Patient Info

New Health Forms

Billing and Insurance

Prescription Refills

New Health Forms

New Patient Questionnaire (PDF)
Newborn Questionnaire (PDF)
18+ Authorization (PDF)
Parental Authorization (PDF)
HIPPA (PDF)
Transfer of Medical Records (PDF)
Release of Medical Records (PDF)
Update Demographics (PDF)
Sports form (PDF)

Hours

Monday - Friday 9:00 AM - 5:00 PM
Call us: (401) 438-6888

Emergencies

After Hours Hotline
Poison Control:
1-800-222-1222

Resources

Patient Portal
Online Screening Tools - CHADIS
Frequently Asked Questions
Learning Library

Our Address

450 Veterans Memorial Parkway, Building 10
East Providence,
RI 02914

(401) 438-6888