New Patient Forms
Once you've selected a Valley Children's pediatrician, be sure to bring your insurance card, immunization record, and the completed following forms to your first visit:
Patient Registration Form | En Español
Patient Health Information | En Español
General Consent to Treatment | En Español
Authorization for and Consent to Surgery or Procedures | En Español
Financial Policy | En Español
Third Party Consent Authorization | En Español
Acknowledgement of Notice of Privacy | En Español
Caregiver Affidavit | En Español
Authorization to Use and/or Disclose Health Information: