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Vaccine Information Statements (VIS)
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2 Months of Age
4 & 6 Months of Age
9 Months of Age
1 Year of Age
15 Months of Age
2 Years of Age
4 Years of Age
11 Years of Age
16 Years of Age
18 Years of Age
Upload On-line Forms
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ADHD/Vanderbilt Forms
HIPAA Forms
New Patient Forms
Sport Physical Form
Printable Forms
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All Printable Forms
Our Providers
Pediatricians
>
Gregory W. Anderson, DO
Elizabeth Farnsworth, MD
Cara M. Hamilton, MD
Margaret F. Kuehler, MD
David W. Mueller, DO
Lori A. Strong, MD
David B. Whitney, MD - Retired
Extended Providers
>
Jenny McIntosh, PA-C
Nodia Berglund, PA-C
Marcene Bloom, PA-C
Suzanne Newsom, CNP
Brittany Rieman, PA-C
Medical Records Release
Patient Portal
Immunization Policy
Employment
Business Office
General Pediatrician
Laboratory
Nursing
X-ray Department
Policies
Medication Refills
Failure to Keep Appointment
Billing
Insurance
Medical Records
New Patients
Notice of Privacy Practices
Federal Identity Policy
Walk-ins and Add-on Policy
Resources
Medical Advice from healthychildren.org
Centers for Disease
American Academy of Pediatrics
ALL FORMS
ADHD – Parent Form
ADHD – Teacher Form
Authorization For Use and Disclosure of PHI To Personal Representatives – Patient under 18 Years of Age
Authorization For Use and Disclosure of PHI To Personal Representatives – Patient 18 Years of Age or Older
Employment Application
Failure to Keep Appointment Policy
Medical Consent Form for Treatment of Minor
Medical Consent Form for Treatment of Unaccompanied Minor
Medical Records Release FROM our Clinic
Medical Records Release TO our Clinic
Notice of Privacy Practices (NPP)
Patient Medical History
Patient Registration
Privacy Practices Acknowledgment & Patient Consent for Use and Disclosure of Protected Health Information
Sports Physical History Form
Vaccine Consent Form
Home
Our Clinic
About Us
Forms
All Forms
Vaccine Information Statements (VIS)
>
2 Months of Age
4 & 6 Months of Age
9 Months of Age
1 Year of Age
15 Months of Age
2 Years of Age
4 Years of Age
11 Years of Age
16 Years of Age
18 Years of Age
Upload On-line Forms
>
ADHD/Vanderbilt Forms
HIPAA Forms
New Patient Forms
Sport Physical Form
Printable Forms
>
All Printable Forms
Our Providers
Pediatricians
>
Gregory W. Anderson, DO
Elizabeth Farnsworth, MD
Cara M. Hamilton, MD
Margaret F. Kuehler, MD
David W. Mueller, DO
Lori A. Strong, MD
David B. Whitney, MD - Retired
Extended Providers
>
Jenny McIntosh, PA-C
Nodia Berglund, PA-C
Marcene Bloom, PA-C
Suzanne Newsom, CNP
Brittany Rieman, PA-C
Medical Records Release
Patient Portal
Immunization Policy
Employment
Business Office
General Pediatrician
Laboratory
Nursing
X-ray Department
Policies
Medication Refills
Failure to Keep Appointment
Billing
Insurance
Medical Records
New Patients
Notice of Privacy Practices
Federal Identity Policy
Walk-ins and Add-on Policy
Resources
Medical Advice from healthychildren.org
Centers for Disease
American Academy of Pediatrics