Forms for New Patients

Below are forms for new patients to the KidsKare locations. Filling out these forms before you come to your new patient appoint could reduce the time you may have to wait for your appointment.

• Bilingual Registration Form/Registro This form provides basic patient information and insurance information needed by our office. Please open and print this form, fill it out and bring it with you to your appointment.


• Bilingual Medical History Form/Historia de Salud
  This form provides necessary information about the patient's medical history needed by our office. Please open and print this form, fill it out and bring it with you to your appointment.


• Bilingual Payment Policy/Nuestra Poliza de Pago
  This is our Payment Policy. You need to sign this form showing you understand our payment policy before your appointment.